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Case Report
Spinal hydatid disease: A case report
1 Faculty of Medicine, European University, Tbilisi, Georgia
2 Internal Medicine and Intensive Therapy Department, Vakhtang Bochorishvili Clinic, Tbilisi, Georgia
3 Internal Medicine and Intensive Therapy Department, Tbilisi Central Hospital, Tbilisi, Georgia
4 National Tuberculosis Center, Tbilisi, Georgia
5 Faculty of Medicine, NewVision University, Tbilisi, Georgia, Georgia
6 Radiology Resident, Vian Hospitals, Tbilisi, Georgia
Address correspondence to:
Ahmed Abdelkader
Faculty of Medicine, New Vision University, Tbilisi,
Georgia
Message to Corresponding Author
Article ID: 100014Z16KT2024
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Tsanava K, Shengelia E, Trapaidze L, Khurtsia L, Abdelkader A, Shulaia N. Spinal hydatid disease: A case report. J Case Rep Images Infect Dis 2024;7(2):1–7.ABSTRACT
Introduction: The parasitic tapeworm Echinococcus granulosus causes cystic echinococcosis, also known as hydatidosis. It is a serious medical condition that can show up in a lot of different ways. Although spinal involvement occurs in about 45% of bone echinococcosis cases, it represents only 0.5–4% of all echinococcosis cases. The disease can spread to the spine through hematogenous dissemination, direct invasion, or cerebrospinal fluid seeding from ruptured cysts. While the liver and lungs are the most commonly affected organs, spinal involvement can lead to severe complications, including radiculopathy, motor deficits, and paraparesis. Imaging, such as computed tomography (CT) and (MRI), typically makes the diagnosis by revealing cystic and osteolytic lesions.
Case Report: The patient is a 51-year-old male from the Kakheti region (a region in Georgia) who presented with progressive generalized weakness, nausea, vomiting, and lumbar pain. He had a history of spinal echinococcosis, diagnosed 15 years ago, but was unable to complete antiprotozoal treatment due to intolerance to albendazole. Over the years, his condition deteriorated, leading to lower paraplegia and urinary incontinence, necessitating a suprapubic cystostomy. Imaging revealed extensive septated cystic lesions in Th4-S1, which spread to the ribs and subcutaneous tissues. Despite neurosurgical intervention to reduce the cyst burden, the infestation persisted. Multiple hospitalizations were required for complications, such as urinary tract infections and pneumonia. Joint supervision managed the patient’s condition, but he continued to experience spherocyte discharge from numerous fistulas.
Conclusion: This case underscores the severe and chronic nature of spinal echinococcal infection, particularly when complete antiprotozoal treatment is not feasible. The patient did not experience severe neurological complications despite the extensive disease burden and the development of multiple vertebral-cutaneous fistulas, possibly due to the continuous drainage of spherocytes. This unusual clinical course highlights the importance of comprehensive management and the potential impact of innovative approaches on managing complex parasitic infections.
Keywords: Hydatid spine disease, Spinal echinococcosis, Spinal hydatidosis, Vertebral-cutaneous fistula
SUPPORTING INFORMATION
Author Contributions
Ketevan Tsanava - Acquisition of data, Drafting the article, Final approval of the version to be published
Elene Shengelia - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Lia Trapaidze - Acquisition of data, Drafting the article, Final approval of the version to be published
Lali Khurtsia - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Ahmed Abdelkader - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Natali Shulaia - Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Ketevan Tsanava et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
