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[Osseous echinococcosis]
R J Wirbel1, P E Mues, W E Mutschler
1Abteilung Unfall, Hand- und Wiederherstellungschirurgie, Universität des Saarlandes, Homburg/Saar.
Summary
Hydatid disease, a rare bone infection caused by Echinococcus tapeworm larvae, can severely damage pelvic structures. This case highlights extensive pelvic resection and prosthetic replacement for extensive bone hydatid disease.
Area of Science:
- Parasitology
- Orthopedic Surgery
- Radiology
Background:
- Hydatid disease typically affects the liver, with primary bone involvement being exceptionally rare (<2%).
- Echinococcus tapeworm larval stages cause parasitic cysts, leading to tissue destruction.
Observation:
- A rare case of extensive left-sided pelvic hydatid disease is presented.
- The infestation caused severe destruction of the hip joint, os pubis, ileum, and femoral head.
Findings:
- Surgical management involved pelvic resection and prosthetic replacement, followed by a second hip replacement due to recurrence.
- A custom-made CAD device was necessary to address pelvic instability after initial prosthetic failure.
- Chemotherapy with mebendazole was administered alongside surgical interventions.
Implications:
- This case underscores the importance of radical resection in managing osseous hydatid disease.
- Advanced reconstructive techniques, including CAD, are crucial for complex pelvic reconstructions.
- Multidisciplinary approaches are vital for successful treatment of rare parasitic bone infections.