Abstract
The spleen is a rare location for hydatid cysts with the larvae reaching the site after escaping the hepatic and pulmonary filters. For most surgeons, splenectomy is the primary treatment in such cases which aims at eradicating the disease while decreasing the chances of recurrence by removing the intact cyst. While this is true, the risks of other two parasitic infections are increased, namely malaria and babesiosis. In the case presented here, the spleen was preserved after extirpating the cyst to keep the patient’s immunity against malaria, which is endemic in our region.
[1] Abu-Eshy S.A. 1998. Some rare presentations of hydatid cyst (Echinococcus granulosus). Journal of the Royal College of Surgeons of Edinburgh & Ireland, 43, 347–352. Search in Google Scholar
[2] Amr S.S., Amr Z.S., Jitawi S., Annab H. 1994. Hydatidosis in Jordan: an epidemiological study of 306 cases. Annals of Tropical Medicine and Parasitology, 88, 623–627. Search in Google Scholar
[3] Annobil S.H., Okeahialam T.C., Jamjoom G.A., Bassuni W.A. 1994. Malaria in children — experience from Asir region, Saudi Arabia. Annals of Saudi Medicine, 14, 467–470. Search in Google Scholar
[4] Bauman R.W. (Ed.). 2004. Microbiology. Pearson Benjamin Cummings. San Francisco, USA, 649–678. Search in Google Scholar
[5] Boone K.E., Watters D.A. 1995. The incidence of malaria after splenectomy in Papua New Guinea. British Medical Journal, 311, 1273. Search in Google Scholar
[6] Bradley D.J., Warhurst D.C., Blaze M., Smith V. 1998. Malaria imported into the United Kingdom in 1996. Eurosurveillance, 3, 40–42. Search in Google Scholar
[7] Cöl C., Cöl M., Lafçi H. 2003. Unusual Localizations of Hydatid Disease. Acta Medica Austriaca, 30, 61–64. DOI: 10.1046/j.1563-2571.2003.30081.x. http://dx.doi.org/10.1046/j.1563-2571.2003.30081.x10.1046/j.1563-2571.2003.30081.xSearch in Google Scholar
[8] Dar M.A., Shah O.J., Wani N.A., Khan F.A., Shah P. 2002. Surgical management of splenic hydatidosis. Surgery Today, 32, 224–229. http://dx.doi.org/10.1007/s00595020002510.1007/s005950200025Search in Google Scholar
[9] Davidson R.N., Wall R.A. 2001. Prevention and management of infections in patients without a spleen. Clinical Microbiology and Infection, 7, 657–660. DOI: 10.1046/j.1198-743x.2001.00355.x. http://dx.doi.org/10.1046/j.1198-743x.2001.00355.x10.1046/j.1198-743x.2001.00355.xSearch in Google Scholar
[10] Franquet T., Montes M., Lecumberri F.J., Esparza J., Bescos J.M. 1990. Hydatid disease of the spleen. Imaging findings in nine patients. American Journal of Roentgenology, 154, 525–528. Search in Google Scholar
[11] Garnham P.C., Donnelly J., Hoogstraal H., Kennedy C.C., Walton G.A. 1969. Human babesiosis in Ireland: further observations and the medical significance of this infection. British Medical Journal, 4, 768–770. Search in Google Scholar
[12] Henríquez C., Hinojosa J.C., Ventosilla P., Infante B., Merello J., Mallqui V., Verastegui M., Maguiña C. 2004. Report of an unusual case of persistent bacteremia by Bartonella bacilliformis in a splenectomized patient. American Journal of Tropical Medicine and Hygiene, 71, 53–55. Search in Google Scholar
[13] Holdsworth R.J., Irving A.D., Cuschieri A. 1991. Postsplenectomy sepsis and its mortality rate: actual versus perceived risks. British Journal of Surgery, 78, 1031–1038. DOI: 10.1002/bjs.1800780904. http://dx.doi.org/10.1002/bjs.180078090410.1002/bjs.1800780904Search in Google Scholar
[14] Kabaalioğlu A., Ceken K., Alimoglu E., Apaydin A. 2006. Percutaneous imaging-guided treatment of hydatid liver cysts: do long-term results make it a first choice? European Journal of Radiology, 59, 65–73. DOI: 10.1016/j.ejrad.2006.01.014. http://dx.doi.org/10.1016/j.ejrad.2006.01.01410.1016/j.ejrad.2006.01.014Search in Google Scholar
[15] King H., Schmacker H.B. 1952. Splenic studies: Susceptibility to infection after splenectomy performed in infancy. Annals of Surgery, 136, 239–242. http://dx.doi.org/10.1097/00000658-195211000-0000410.1097/00000658-195211000-00004Search in Google Scholar
[16] Kotsanas D., Al-Souffi M.H., Waxman B.P., King R.W.F., Polkinghorne K.R., Woolley I.J. 2006. Adherence to guidelines for prevention of post splenectomy sepsis. Age and sex are risk factors: a five-year retrospective review. ANZ Journal of Surgery, 76, 542–547. DOI: 10.1111/j.1445-2197.2006.03775.x. http://dx.doi.org/10.1111/j.1445-2197.2006.03775.x10.1111/j.1445-2197.2006.03775.xSearch in Google Scholar
[17] Looareesuwan S., Suntharasamai P., Webster H.K., Ho M. 1993. Malaria in splenectomized patients. Report of four cases and review. Clinical Infectious Diseases, 16, 361–366. Search in Google Scholar
[18] Lynch A.M., Kapila R. 1996. Overwhelming postsplenectomy infection. Infectious Disease Clinics of North America, 10, 693–707. DOI: 10.1016/S0891-5520(05)70322-6. http://dx.doi.org/10.1016/S0891-5520(05)70322-610.1016/S0891-5520(05)70322-6Search in Google Scholar
[19] Malik G.M., Seidi O., El-Taher A., Mohammed A.S. 1998. Clinical aspects of malaria in the Asir region, Saudi Arabia. Annals of Saudi Medicine, 18, 15–17. Search in Google Scholar
[20] Mitchell I., McNeillis N., Bowden F.J., Nikolic G. 2002. Electrocardiographic myocardial infarction pattern in overwhelming post-splenectomy sepsis due to Capnocytophaga canimorsus. Internal Medicine Journal, 32, 415–418. DOI: 10.1046/j.1445-5994.2002.00236.x. http://dx.doi.org/10.1046/j.1445-5994.2002.00236.x10.1046/j.1445-5994.2002.00236.xSearch in Google Scholar PubMed
[21] Ozdogan M., Baykal A., Keskek M., Yorgancy K., Hamaloglu E., Sayek I. 2001. Hydatid cyst of the spleen: treatment options. International Surgery, 86, 122–126. Search in Google Scholar
[22] Petithory J.C., Khelil A., Galeazzi G., Ardoin F. 2005. Malaria in splenectomized patients. Three fatal cases. Presse Médicale, 34, 51. Search in Google Scholar
[23] Prousalidis J., Tzardinoglou K., Sgouradis L., Katsohis C., Aletras H. 1998. Uncommon sites of hydatid disease. World Journal of Surgery, 22, 17–22. http://dx.doi.org/10.1007/s00268990034310.1007/s002689900343Search in Google Scholar PubMed
[24] Versaci A., Scuderi G., Rosato A., Angio L.G., Oliva G., Sfuncia G., Saladino E., Macri A. 2005. Rare localizations of echinococcosis: personal experience. ANZ Journal of Surgery, 75, 986–991. DOI: 10.1111/j.1445-2197.2005.03588.x. http://dx.doi.org/10.1111/j.1445-2197.2005.03588.x10.1111/j.1445-2197.2005.03588.xSearch in Google Scholar
[25] Waghorn D.J., Mayon-White R.T. 1997. A study of 42 episodes of overwhelming post-splenectomy infection: is current guidance for asplenic individuals being followed? Journal of Infection, 35, 289–294. http://dx.doi.org/10.1016/S0163-4453(97)93232-110.1016/S0163-4453(97)93232-1Search in Google Scholar
[26] Zerem E., Nuhanovic A., Caluk J. 2005. Modified pair technique for treatment of hydatid cysts in the spleen. Bosnian Journal of Basic Medical Sciences, 5, 74–78. Search in Google Scholar
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