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Disseminated alveolar echinococcosis resembling metastatic malignancy: a case report.
- Source :
-
Journal of medical case reports [J Med Case Rep] 2017 Apr 18; Vol. 11 (1), pp. 113. Date of Electronic Publication: 2017 Apr 18. - Publication Year :
- 2017
-
Abstract
- Background: Alveolar echinococcosis is a potentially lethal zoonosis caused by larval forms of the tapeworm Echinococcus multilocularis. Humans are aberrant intermediate hosts who become infected by ingestion of egg-contaminated food or water or via physical contact with domestic or wild animals that carry the parasite in their small intestine. In humans, the disease usually affects the liver and can spread to other organs causing metastatic infiltration. In this report, we describe an advanced presentation of human alveolar echinococcosis mimicking metastatic malignancy.<br />Case Presentation: A 62-year-old white woman was evaluated for fever, jaundice, and abdominal pain, associated with significant weight loss. She lived in a rural area in Switzerland and used to eat wild forest fruits and mushrooms. She owned cats that used to hunt rodents. On physical examination, she appeared severely ill with cachexia, altered mental status, jaundice, and massive hepatomegaly. Laboratory tests showed cholestasis with preserved liver function. An abdominal computed tomography scan showed an enlarged liver with a huge cystic mass in the right lobe extending into the left lobe, infiltrating her hepatic hilum, causing intrahepatic bile duct dilation and occlusion of her right portal vein. A chest computed tomography scan showed multiple calcified bilateral pulmonary nodules. Her clinical and radiological presentation resembled an advanced neoplastic disease. Serologic tests for Echinococcus multilocularis were positive. The diagnosis of alveolar echinococcosis was established on her past history of exposure, imaging, and serology results.<br />Conclusions: Clinical presentation and radiologic imaging findings of disseminated alveolar echinococcosis can mimic metastatic malignancy, and diagnosis can be challenging in atypically advanced cases. As the incidence of human alveolar echinococcosis appears to be increasing in Europe and Switzerland, physicians should be aware of alveolar echinococcosis, its epidemiology, and its clinical features.
- Subjects :
- Animals
Bile Ducts pathology
Cats
Diagnosis, Differential
Drainage
Echinococcosis physiopathology
Endemic Diseases
Fatal Outcome
Female
Humans
Liver pathology
Liver Neoplasms pathology
Middle Aged
Multiple Organ Failure
Neoplasms, Second Primary pathology
Shock, Septic
Switzerland
Albendazole therapeutic use
Anthelmintics therapeutic use
Bile Ducts parasitology
Echinococcosis diagnosis
Echinococcosis therapy
Feeding Behavior
Liver parasitology
Subjects
Details
- Language :
- English
- ISSN :
- 1752-1947
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of medical case reports
- Publication Type :
- Academic Journal
- Accession number :
- 28416007
- Full Text :
- https://doi.org/10.1186/s13256-017-1279-2