Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2024; 16(2): 279-285
Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.279
Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation: A case report
Miao-Miao Wang, Xiu-Qing An, Jin-Ping Chai, Jin-Yu Yang, Ji-De A, Xiang-Ren A
Miao-Miao Wang, Xiu-Qing An, School of Continuing Education, Qinghai University, Xining 810000, Qinghai Province, China
Jin-Ping Chai, Department of Internal Medicine-Cardiovascular, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
Jin-Yu Yang, Department of General Surgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
Ji-De A, Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
Xiang-Ren A, Department of Medical Laboratory Medicine, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
Co-first authors: Miao-Miao Wang and Xiu-Qing An.
Co-corresponding authors: Ji-De A and Xiang-Ren A.
Author contributions: Wang MM, An XQ and Chai JP conceptualized and designed the research; Yang JY, A JD and A XR screened patients and acquired clinical data; Wang MM, An XQ and Chai JP collected blood specimen and performed laboratory analysis; Yang JY, A JD and A XR performed Data analysis; Wang MM, An XQ and Chai JP wrote the paper. All the authors have read and approved the final manuscript. Wang MM and An XQ prepared the first draft of the manuscript. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. Both A JD and A XR have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. A XR conceptualized, designed, and supervised the whole process of the project. He searched the literature, revised and submitted the early version of the manuscript with the focus on the diagnosing and treating this rare condition: A mixed infection of both Echinococcus species with abdominal wall invasion and sinus tract formation. This collaboration between A JD and A XR is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by National Natural Science Foundation of China, No. 82260412.
Informed consent statement: This published consent was obtained from the patients or their representatives.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji-De A, MD, Doctor, Department of Hepatic Hydatidosis, Qinghai Provincial People's Hospital, No. 2 Gonghe Road, Chengdong District, Xining 810007, Qinghai Province, China. 491607355@qq.com
Received: November 16, 2023
Peer-review started: November 16, 2023
First decision: December 25, 2023
Revised: December 29, 2023
Accepted: January 25, 2024
Article in press: January 25, 2024
Published online: February 27, 2024
Abstract
BACKGROUND

Hepatic cystic and alveolar echinococcosis coinfections, particularly with concurrent abscesses and sinus tract formation, are extremely rare. This article presents a case of a patient diagnosed with this unique presentation, discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.

CASE SUMMARY

A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis, accompanied by abdominal wall abscesses and sinus tract formation. Initial conventional imaging examinations suggested only hepatic cystic echinococcosis, but intraoperative and postoperative pathological examination revealed the coinfection. Following radical resection of the lesions, the patient’s condition improved, and she was discharged soon thereafter. Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing. Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare, the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.

CONCLUSION

Lesions involving the abdominal wall and sinus tract formation, may require radical resection. Long-term prognosis includes albendazole and follow-up examinations.

Keywords: Cystic echinococcosis, Alveolar echinococcosis, Abdominal wall abscess, Surgical treatment, Sinus tract, Case report

Core Tip: Echinococcosis, also known as hydatid disease, is a zoonotic parasitic disease caused by echinococcus infection, mostly parasitic in the liver. There are two common pathogenic types of hepatic echinococcosis, Echinococcus granulosus and Echinococcus multilocularis. Infection with a single species of echinococcus was common, while co-infection with two species of echinococcus was rare, accounting for only 0.92% of the patients with hepatic echinococcosis. This article introduces the diagnosis and treatment of a patient with co-infection of two types of hepatic echinococcosis, abdominal wall abscess and sinus formation.