Lodhia Jay, Chugulu Samwel, Sadiq Adnan, Msuya David, Mremi Alex
Department of General Surgery, Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi, Tanzania.
J Med Case Rep. 2020 Oct 24;14(1):200. doi: 10.1186/s13256-020-02524-4.
Echinococcosis is a parasitic disease caused by Echinococcus granulosus and causes cystic lesions in the liver and lungs commonly. It is endemic in many parts of the world, and though humans are incidental hosts of the parasite, the disease can have severe consequences.
We present two patients from pastoralist (Maasai) communities in rural Tanzania with long-standing chest pain accompanied by hemoptysis. Both were managed surgically after diagnosis, but one patient died of the complications following rapture of the cyst during surgery. Histopathological evaluation of the specimens confirmed the diagnosis of giant hydatid cysts.
Animal-keeping communities such as the Maasai are at risk of echinococcosis because of their close proximity to animals. The diagnosis can be made on the basis of history and radiological as well as laboratory findings. Surgery is a recommended mode of treatment, though it carries a high risk, especially when the cyst ruptures. Primary preventive measures are thus necessary in order to avoid the secondary and tertiary complications of the management of giant hydatid cysts, which is difficult in resource-limited endemic areas.
棘球蚴病是由细粒棘球绦虫引起的一种寄生虫病，通常在肝脏和肺部引起囊性病变。该病在世界许多地区呈地方性流行，尽管人类是该寄生虫的偶然宿主，但这种疾病可能会产生严重后果。
我们报告了两名来自坦桑尼亚农村牧民（马赛族）社区的患者，他们长期胸痛并伴有咯血。两人在确诊后均接受了手术治疗，但其中一名患者在手术期间因囊肿破裂引发并发症而死亡。对标本进行的组织病理学评估证实为巨大包虫囊肿。
像马赛族这样的畜牧社区由于与动物密切接触，有感染棘球蚴病的风险。可根据病史、影像学及实验室检查结果做出诊断。手术是推荐的治疗方式，不过手术风险很高，尤其是囊肿破裂时。因此，有必要采取一级预防措施，以避免在资源有限的流行地区处理巨大包虫囊肿时出现二级和三级并发症，而处理这些并发症很困难。
