Hydatid cyst of the heart presenting as cerebral and cerebellar infarction

A 37-year-old Italian man presented with acute fever, headache, confusion and right arm clumsiness. Computerised axial tomography of the head showed right cerebellar, left parietal and frontal lobe haemorrhagic infarcts. An X-ray film of the chest showed a circular mass adjacent of the heart. On aspiration of the mass lesion during bronchoscopy, we found hydatid hooklets. A left ventriculogram showed this cyst to be attached to the pericardium. Subsequently, we performed left thoracotomy and the hydatid cyst was excised (though incompletely). The patient was treated with mebendazole and made a complete recovery.