Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 12:28:e01501.
doi: 10.1016/j.idcr.2022.e01501. eCollection 2022.

Isolated splenic cystic echinococcosis and albendazole hepatotoxicity

Nikolaos Moussas  1 , Sotirios Adamidis  2 , Nikolaos Adamidis  3 , Charalabos Stratopoulos  4 , Panagiotis Gargalianos-Kakolyris  1
Affiliations
Case Reports

Isolated splenic cystic echinococcosis and albendazole hepatotoxicity

Nikolaos Moussas et al. IDCases. .

Abstract

Isolated splenic cystic echinococcosis is a rare condition. In Greece the number of cases has declined substantially in the last 20 years. The spleen is the second most common extrahepatic site of cystic echinococcosis. Albendazole is safe, but mebendazole can be used as a substitute, in case of adverse reaction. Our patient was diagnosed with isolated splenic echinococcal cyst, during the investigation for newly diagnosed type 2 diabetes mellitus. We opted for elective splenectomy, based on a risk assessment due to the patient's working conditions, and treatment with albendazole represented a safety measure until surgery was possible. The patient developed acute hepatocellular injury to albendazole after eight weeks of treatment. This was confirmed through rechallenge with albendazole after discontinuation of the drug. Postsplenectomy the treatment with mebendazole proved to be safe with no adverse reactions. Even though, albendazole is known to be safe, monitoring of hepatic enzymes and full blood count should be offered. In case of toxicities, mebendazole with or without praziquantel can be used. Toxicity to mebendazole can be similar to albendazole but a trial is worthwhile. In our patient, treatment with mebendazole was uneventful.

Keywords: Albendazole; Echinococcosis; Echinococcus; Hepatotoxicity; Mebendazole.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CT slice of the splenic cystic lesion with dimensions of 8.7 × 9.5 × 11 cm, with a thick calcified wall.
Fig. 2
Fig. 2
CT slice of the lower edge of the cystic lesion; a smaller, more heterogenous lesion is noted with dimensions of 4.3 × 2.7 × 4 cm.
Fig. 3
Fig. 3
Axial MRI slice of the larger cystic lesion.
Fig. 4
Fig. 4
Axial MRI slice of the large cystic lesion with high signal in T2 and low in T1.
Fig. 5
Fig. 5
Axial MRI slice of the larger cystic lesion, described with high signal in T2 and low in T1.
Fig. 6
Fig. 6
CT slice of the second smaller lesion that was more heterogenous.
Fig. 7
Fig. 7
MRI slice of the smaller cystic lesion with low intensity signal in both T1 and T2 sequences.
Fig. 8
Fig. 8
The spleen during first stages of operation.
Fig. 9
Fig. 9
Diaphragmatic surface of the spleen after splenectomy.
Fig. 10
Fig. 10
Visceral surface of the spleen after splenectomy.
Fig. 11
Fig. 11
Details of surgical specimen dissected.
Fig. 12
Fig. 12
Details of dissected spleen, layers of calcifications are visible. Extended haemorrhagic infarct can also be seen.
See this image and copyright information in PMC

References

    1. Gupta V., Kaira V., Sharma J., et al. Primary hydatid cyst of spleen: a rare entity. J Trop Dis. 2014;2(2):1. doi: 10.4172/2329-891X.1000131. - DOI
    1. Lianos G.D., Lazaros A., Vlachos K., et al. Unusual locations of hydatid disease: a 33 years’ experience analysis on 233 patients. Updates Surg. 2015;67(3):279–282. doi: 10.1007/s13304-015-0291-6. - DOI - PubMed
    1. Griffin D.O., Donaghy H.J., Edwards B. Management of serology negative human hepatic hydatidosis (caused by Echinococcus granulosus) in a young woman from Bangladesh in a resource-rich setting: a case report. IDCases. 2014;1(2):17–21. doi: 10.1016/j.idcr.2014.02.003. - DOI - PMC - PubMed
    1. Brunetti E., Kern P., Vuitton D. Writing panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1–16. doi: 10.1016/j.actatropica.2009.11.001. - DOI - PubMed
    1. Hashemzadeh S., Rezabakhsh A., Rahbarghazi R., Amini H. A giant splenic hydatid cyst: why calcified cysts should not be considered as a dead cyst. Clin Case Rep. 2021;9:269–273. doi: 10.1002/ccr3.3512. - DOI - PMC - PubMed

Publication types

LinkOut - more resources