Title : Primary multiple cerebral hydatid cysts: an unusual case report in European countries.
Abstract:
Introduction: Cystic echinococcosis is a zoonotic infection that occurs worldwide. Humans are infected through ingestion of parasite eggs in contaminated food, water or through direct contact with infected dogs, which are the definite host. Humans are accidental intermediate host, usually occur in children and young adults. Cystic echinococcosis is endemic in Mediterranean, South American, Middle Eastern, Central Asia, East Africa countries and Australia. The liver is the most common organ involved, followed by lungs. In the brain hydatid cyst have been reported only in 2% of cases.
Primary cerebral hydatid disease is a rare entity, but should be considered in the differential diagnosis of cerebral lesions, not only in children, even in European countries, although it is not currently evidenced in these countries.
Objectives: The main of this purpose is to demonstrate a rare primary cerebral hydatid cysts, with obvious clinical symptoms and imaging findings, which is an unusual case report in European countries
Material: We describe the case of 22 years old female, which shows a primary multiple cerebral hydatid cysts, because we did not detect any other organs affected by the disease, in the imaging examinations re-evaluated during the stay or after exiting the hospital.
Results: In the RMI examination patient shows six supratentorial cerebral lesions, which were prescribed as lesions of intraparenchymal nonenhancing hypodense lesion with a well-circumscribed border and no pericystic edema. Respectively, one in the left frontal lobe (2.9x2.7 cm), one in the left fronto-parietal lobe (4.6x3.8 cm), one in the left temporo-parietal lobe (4.5x4.1 cm), one in right occipital lobe (3.1x2.7 cm) and two of them in right frontal lobe (4.3x3.9 cm, 3.0x2.7 cm) presented with presence of thin septa. Serological tests for hydatid disease was positive. The patient underwent 2 neurosurgical interventions, for a period of 2 weeks, for the removal of all cerebral hydatid cysts and was kept in ICU for few days, after each of them. Patient had fast neurological recovery. To prevent recurrence, the patient was put on therapy with albendazole, 400 mg x 2, per day.
Conclusions: Hydatid disease is often neglected, even in endemic areas or not early diagnosed till the lesions assumes an enormous size. It seems an dramatic and uncommon disease, but is a totally curable disease. Control and vaccination of the intermediate hosts is important to interrupt the transmission cycle ant to prevent humans infections.
