Hydatid disease: A rare cause of fracture nonunion

Abstract

Hydatid disease is an infrequent parasitic infestation caused by cestode, most commonly, Echinococcus granulosus. Bone involvement is distinctly uncommon. We would like to share our experience of a rare case of hydatid disease of femur in a 24-year-old male who presented with nonunion of subtrochanteric fracture. Histopathology showed typical lamellated wall and dagger-shaped hooklets. In view of its rarity, hydatid disease often remains an unsuspected infection of the bone.

Keywords: Bone; fracture nonunion; hydatid disease.

Figure 1

Preoperative radiograph showing subtrochanteric fracture of right femur. Note absence of any obvious clue suggestive of primary bone pathology

Figure 2

Postoperative films showing in situ intramedullary nail. There was lysis around the implant, resorption of the fracture ends, and no evidence of callus formation

Figure 3

Part of specimen showing pearly white cyst wal

Figure 4

(a) Thick eosinophilic lamellated membrane/parasite exocyst (H and E, ×200). (b) Dagger-shaped refractile hooklets (arrow) of Echinococcus and tiny fragments of germinal layer (H and E, ×400)