Liver echinococcosis in a renal transplant patient: a particularly intriguing case report

A renal transplant patient was admitted to his local town hospital with suspected acute pancreatitis (jaundice, abdominal pain and fever). Despite intensive medical care (including endoscopic retrograde cholangiopancreatography) and several negative radiological exams (including computed tomography and nuclear magnetic resonance spectroscopy), no certain diagnosis could be made. After 1 month, the patient was transferred to our facility, where a new sonography was performed, as a prelude to a liver biopsy, which showed the presence of multiple fluid-filled cysts (up to 8 cm), strongly suggestive of hydatid liver disease. Empirical therapy with albendazole was started, and cyclosporine dosage, previously reduced, was restored. This enabled a prompt resolution of the disease and the progressive fibrous evolution of the cysts over the 18-month follow-up period, with no damage to renal function, which remained stable.