Rare and Unusual Presentation of a Hydatid Cyst: A Case Report

Hydatid cyst is a parasitic disease that is widespread in different parts of the world. It affected both sexes equally and was more seen in young persons. The liver and lung are the organs most affected by the parasite. Cardiac localization is rare but severe. A pericardial location without cardiac damage is exceptional. Echocardiography is a preferred and efficient modality for the diagnosis of cardiac hydatidosis, it was the initial modality for the diagnosis in all patients. Serologic tests are a helpful supplement but false-negative results were possible. Surgical excision was performed in the vast majority of cases. Albendazole was used for preoperative sterilization and post operative period up to six months to prevent recurrence. We report the observation of a patient with a hydatid cyst with ruptured hepatic localization in the pericardium revealed by a pericardial effusion syndrome.

Presentation of the Case: A 25-year-old patient with no previous history, admitted with progressive pericardial effusion syndrome with palpation of an epigastric mass. The chest X-ray showed cardiomegaly, the thoracoabdominal CT scan showed a hydatid cyst of the left lobe of the liver probably ruptured in the pericardium. The ECG showed a micro-voltage and the echo heart rate indicated a pericardial effusion of medium abundance. Hydatid serology was positive. The patient had a hydatid cyst dome resection of the left lobe with drainage and emptying of the pericardium. Patient died in a board of septic shock. The pericardial localization of hydatid cyst without cardiac involvement is exceptional and potentially fatal.