Disseminated Echinococcus multilocularis Infection without Liver Involvement in Child, Canada, 2018

Abstract

An immunocompetent child in Canada received a diagnosis of disseminated alveolar Echinococcus multilocularis infection. The case lacked typical features of liver involvement and was possibly related to a rare congenital portosystemic shunt. We summarize the rapidly evolving epidemiology of E. multilocularis parasites in Canada.

Keywords: Canada; Echinococcus multilocularis; alveolar; children; hydatid; liver; parasites; zoonoses.

Figure 1

Coronal contrast enhanced CT (computed tomography) of the abdomen of a child with disseminated Echinococcus multilocularis infection without liver involvement, Canada, 2018. There is a large irregular hypodense left renal lesion (red arrow). A large porto-systemic shunt is partially visualized (white arrow).

Figure 2

Kidney core biopsy of a child with disseminated Echinococcus multilocularis infection without liver involvement, Canada, 2018. Shown are folded laminated membrane (short black arrows) encircling variable-sized cystic structures (black circles) containing calcified and necrotic debris and dense periparasitic fibrosis (long black arrows), in a background of chronic inflammation and fibrosis. No residual normal kidney parenchyma was seen (hematoxylin and eosin stain, original magnification × 40). Inset at lower right shows laminar membrane, 18–19.4 μm in thickness in a background of fibrosis (Masson trichrome, original magnification ×40). Insert at upper left shows scolex attached to the paraffin edge of the block (original magnification ×40).