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Year : 2018  |  Volume : 8  |  Issue : 2  |  Page : 101-102  

Huge interventricular septal hydatid: A rare fatal case


1 Department of Cardiology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India
2 Department of Cardiology, IPGME and R, Kolkata, West Bengal, India

Date of Web Publication27-Dec-2018

Correspondence Address:
Dr Rakesh Agarwal
243, G.T Road (N), Laxmi Niketan, Flat-2E, Liluah, Howrah - 711 204, West Bengal
India
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DOI: 10.4103/tp.TP_43_18

PMID: 30693216

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How to cite this article:
Agarwal R, Sarkar A, Sinha DP. Huge interventricular septal hydatid: A rare fatal case. Trop Parasitol 2018;8:101-2

How to cite this URL:
Agarwal R, Sarkar A, Sinha DP. Huge interventricular septal hydatid: A rare fatal case. Trop Parasitol [serial online] 2018 [cited 2019 May 22];8:101-2. Available from: http://www.tropicalparasitology.org/text.asp?2018/8/2/101/248685



A 55-year-old female patient presented with exertional dyspnea for 6 months. She had no history of exposure to pet animals. Her physical examination and cardiac examination were normal. Routine laboratory investigations revealed hemoglobin 14 g/dL, total leucocyte count of 10,200/mm3, and platelet count of 2, 10,000/mm3. Liver function tests were normal. A chest X-ray revealed an enlarged cardiac shadow with a thin rim of calcification inside the cardiac silhouette [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d. Echocardiography revealed a large heterogeneous cystic mass with multiple daughter cysts occupying the interventricular septum [Figure 1]b. Cardiac magnetic resonance imaging (MRI) corroborated the echocardiographic findings [Figure 1]c and [Figure 1]d. An echinococcus IgM antibody tested positive. The patient was diagnosed with cardiac hydatid disease with no evidence of disease elsewhere. She developed anaphylactic shock and passed away before further therapy could be planned.
Figure 1: (a) Chest X-ray with thin rim of calcification delineating hydatid cyst (b) echocardiographic image of huge cyst with multiple daughter cysts invading the whole of septum (c and d) magnetic resonance imaging images corroborating the same

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The most common sites of hydatid cysts are the liver, lungs, muscles, bones, kidneys, spleen, and the brain.[1] Cardiac hydatids are rare occurring only in 0.5%–2% of all cases.[2] They involve the left ventricle in 60% cases followed by the right ventricle, pericardium, pulmonary artery, and left atrial appendage.[2],[3] Involvement of interventricular septum occurs in 4% of all cardiac cases.[3] Cardiac hydatids are usually asymptomatic with symptoms in only 10% cases.[4] Discharge of cyst content or cyst rupture can lead to anaphylactic shock. Echocardiography, computed tomography, and MRI may clinch the diagnosis. A positive ELISA to echinococcal antigen confirms the diagnosis. We have described one of the rarest presentations of echinococcal disease through this report and its catastrophic outcome.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Sachar S, Goyal S, Goyal S, Sangwan S. Uncommon locations and presentations of hydatid cyst. Ann Med Health Sci Res 2014;4:447-52.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Ibn Elhadj Z, Boukhris M, Kammoun I, Halima AB, Addad F, Kachboura S, et al. Cardiac hydatid cyst revealed by ventricular tachycardia. J Saudi Heart Assoc 2014;26:47-50.  Back to cited text no. 2
    
3.
Sabzi F, Faraji R. Hydatid cyst of the interventricular septum causing complete heart block and postoperative ventricular septal defect. Indian J Crit Care Med 2014;18:473-5.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Ipek G, Omeroglu SN, Goksedef D, Balkanay OO, Kanbur E, Engin E. Large cardiac hydatid cyst in the interventricular septum. Tex Heart Inst J 2011;38:719-22.  Back to cited text no. 4
    


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