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East and Central African Journal of Surgery, Vol. 15, No. 1, Mar-Apr, 2010, pp. 139-140 Case Report Hydatid Cyst of the Left Thigh: A Case Report.A.A. Abebe Department of Orthopaedic Surgery Menilik II Hospital AA Ethiopia, E-mail asfdrdilla07@yahoo.com Code Number: js10023 A 25-year old female patient from Gurage zone rural area, a shepherd by occupation presented with a with a cystic swelling of the left thigh which had been gradually increasing in size and became painful. She reported having been taking unboiled pond water from the pond the sheep and other domestic animals used to drink from. She was apparently in a good state of health until 2 years previously when she started to notice swelling of the left upper thigh which gradually increased in size and became painful. For which presented to our center. Introduction Echinococcosis is prevalent in areas where live stokes are raised in association with dogs. In many part of Africa where man, sheep, and dogs live in close contact, the diases can be found. This tape worm species is found in Australia, Argentina, Chile, Africa, Eastern Europe, Middle east , Newzealand, and Mediterranean region. Echinococcus cysts have both intermediate and definitive host. The definitive hosts are dogs that pass eggs in their feces. cysts develop in intermediate host (sheep, Cattle, Humans, Goats, Camel, and horses). Many organs are affected but the most frequently affected sites are the liver, lung, liver, brain, and bone. Skeletal muscle involvement is rare. Case report This is a case report of a twenty five years old female patient from rural area of Ethiopia, a shepherd At farm yard presented with a cystic swelling of lt thigh which increase in size gradually and become painful. On physical examination the pertinent findings were as fallows. Diffuse cystic swelling of the left thigh 18 x10 cm size located at the upper thigh anteriorly with smooth surface non tender and non adherent to overlying skin (Figure 1). Laboratory findings were as fallows, Hematocrite=35%, WBC=8900 Xmm3, eosinophilia. X-ray of the left thigh revealed diffuse soft tissue swelling no bony involvement. Fine needle aspiration done prior to arrival to our center (although it is not recommended) described as fallows: Clear fluidly back ground with no cellular element amorphous pale laminated material seen Suggestive of hydatid cyst. Excision of the mass done where the cysts and daughter cysts were removed in toto. where we could see the eggs of the parasite (Figure 2). Discussion Echinococcosis infection is acquired by ingestion of infective eggs .The usual source of infection is stool of dogs or other carnivores. The transmission is fecal oral route. The parasites causes human morbidity and mortality and also contribute indirectly to human disease by its effect on domestic animals .the usual site of human infestation are Liver, Lung, spleen, bone and brain. Other sites are possible but rare. In endemic areas echinococcosis can be prevented by regular deworming of dogs using praziquantel, by denying dogs access to infected animals, by vaccinating sheep, by safe disposal or boiling of offal are important control measures. Ultrasound evaluation of any cystic lesion in endemic areas is safer than doing fine needle aspiration to prevent rapture and anaphylactic shock. Further Reading
Copyright © 2010 - East and Central African Journal of Surgery The following images related to this document are available:Photo images[js10023f2.jpg] [js10023f1.jpg] |
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