Rupture of Echinococcus granulosus leading to severe hypoxia: preoperative and postoperative management

Area of Science:

• Medicine
• Parasitology
• Pediatric Emergency Medicine

Background:

• Cystic echinococcosis is a parasitic disease caused by Echinococcus granulosus.
• Lung involvement can lead to severe respiratory compromise, especially in pediatric cases.
• A previously healthy 13-year-old boy presented with critical respiratory distress and cyanosis.

Purpose of the Study:

• To report a case of cystic echinococcosis in a pediatric patient presenting with acute respiratory distress.
• To describe the diagnostic process, including imaging and serological tests.
• To detail the successful conservative and surgical management strategies.

Main Methods:

• Clinical presentation and initial management in the emergency department.
• Diagnostic imaging: Chest X-ray and CT thorax scan.
• Treatment: Conservative management, albendazole therapy, endocystectomy with capitonnage, and flexible bronchoscopy for complication management.

Main Results:

• A large air-fluid cavity in the right lung was diagnosed as cystic echinococcosis via CT scan.
• Negative serological tests for echinococcus.
• Successful treatment combining conservative measures, albendazole, surgery, and bronchoscopy resulted in full clinical and radiological resolution.

Conclusions:

• Cystic echinococcosis can present acutely in children, mimicking other respiratory emergencies.
• A multidisciplinary approach involving medical, surgical, and interventional radiology is crucial for optimal outcomes.
• Parenchyma-sparing surgery combined with antiparasitic therapy offers a favorable prognosis.