Complicated cystic echinococcosis (CE) in the right lung of a child – Case report

Introduction: Echinococcosis is a parasitic disease a tapeworm of the echinococcus type in people and animals.

Diagnosis: History, physical, labs, x-ray chest, sonogram of chest & abdomen, CT, MRI, serology. The purpose is to present a case of a two year old with a complex cystic echinococosis in the right lung, with a successful outcome. Girl presents three weeks with cough, fever, and dyspnea.  Oral antibiotics are happening for 25 days, no improvement. In Strumica a chest x-ray is realized and the patient is sent to our institution. At the age of one the patient had first hospital stay for a lower respiratory tract infect. After she had a number of lower respiratory tract infections treated ambulatory. She has a positive family history for echinococcosis. At admittance is pale, a febrile, with a productive cough, dyspnea, BW below the 3rd percentile. On auscultation diminished breathing sounds in the middle and lower segment of the right lung and a finding of many inspiratory crackles. CBC-hemoglobin low, elevated wbc with a predomination of granulocytes. CRP-90..4.13.8mg/l, SE-95/110..10/20.  Blood gases, ABS, liver panel, urine, sputum, mantoux test, ehin test-all negative. X-ray of chest –a large substrate with round form, with sharp demarcations in the lower lobe of the right lung, finding suggestive of a cystic formation. Sonogram of thorax and abdomen-on the right side above the diaphragm a large cystic formation filled with fluid. Eosionphils nasal secretion 30%, and in sputum 20%. CT of thorax –clearly demarcated cystic formation in right lower lung with dimensions 56X42mm, clearly demarcated capsule. I.V antibiotic third generation cephalosporin was administered. The patient was prepared for her operative treatment at the children’s surgery clinic in Skopje. The post-operative check was excellent.

Conclusion: Early diagnosis and fast and correct treatment is most important in successful outcome.