Elkarimi S, Ouldelgadia N, Gacem H, Zouizra Z, Boumzebra D, Blelaabidia B, Elhattaoui M
Service de cardiologie, FMPM, PCIM, CHU Mohammed VI, Marrakech, Maroc.
Service de chirurgie cardiovasculaire, CHU Mohammed VI, Marrakech, Maroc.
Ann Cardiol Angeiol (Paris). 2014 Sep;63(4):267-70. doi: 10.1016/j.ancard.2012.01.003. Epub 2012 Feb 14.
Hydatid disease is a parasitic infection caused by the development of the larval form of the Teania of Echinococcus granulosus. It is endemic in many regions of the world such as the Mediterranean basin. Location without pericardial cardiac involvement is extremely rare. In this case study, we will elaborate the case of an intra-pericardial hydatidosis disease without cardiac location revealed by a tamponade.
AA is a 60-year-old man with no pathological history and who was admitted for a tamponade assessment. Indeed, the cardiovascular examination showed a muffling of the heart sound and signs of a right heart failure. Besides, the ECG shows a microvoltage, and the chest radiography shows cardiomegaly. Moreover, the transthoracic echocardiogram confirmed the presence of an abundant pericardial effusion along with signs of a tamponade. It also reifies the presence of, at the intra-pericardial level, a multiple vesicular formation giving a cluster of grapes highly suggestive of an intra-pericardial hydatid disease. An emergency surgical drainage allowed removing about two liters of suspicious fluid along with cysts and white membranous. The pathological examination of the membranous confirmed the diagnosis of a pericardial hydatid cyst. The performance of a chest CT and an abdominal ultrasound's scan to identify other locations shows no further anomalies. The patient was put under medical treatment (Albendazole(®)) and is showing a good clinical improvement.
The intra-pericardial hydatid disease is another cause of tamponade not to fail despite its rareness, as it is endemic to North African countries.
包虫病是由细粒棘球绦虫幼虫发育引起的寄生虫感染。在地中海盆地等世界许多地区呈地方性流行。无心脏心包受累的部位极为罕见。在本病例研究中,我们将详细阐述一例因心包填塞而发现的无心内定位的心包内包虫病病例。
AA是一名60岁男性,无病史,因心包填塞评估入院。确实,心血管检查显示心音减弱及右心衰竭体征。此外,心电图显示低电压,胸部X线显示心脏增大。而且,经胸超声心动图证实存在大量心包积液及心包填塞体征。它还明确了在心包内存在多个水泡状结构,形成一串葡萄样,高度提示心包内包虫病。紧急手术引流排出了约两升可疑液体以及囊肿和白色膜状物。膜状物的病理检查证实了心包包虫囊肿的诊断。进行胸部CT和腹部超声扫描以确定其他部位,未发现进一步异常。患者接受药物治疗(阿苯达唑),临床情况改善良好。
心包内包虫病尽管罕见,但仍是心包填塞的另一个病因,在北非国家呈地方性流行。