Article
Spino-pelvine manifestation of echinococcus multilocularis
Spino-pelvine Manifestation eines Echinococcus multilocularis
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Published: | May 8, 2019 |
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Objective: Echinococcus manifestation in humans is seldom, manifestation to the bone occur in 1%, primary spinal tape worm manifestation is extremly rare.
Methods: Here, we report a clinical case of a lumboscaral and pelvine tape worm manifestation of Echinococcus multiloccularis in a 56 year old male Caucasian.
Results: A 56 years old male caucasian farmer presented with long lasting low back pain and hypesthesia within the legs. MRI (Figure 1 [Fig. 1]) showed cystic intraspinal as well as osseous lesions within the lumbosacral spine and in the pelvis. CT guided biopsy was taken, without success. Repeated open biopsy was performed, until spinal tape worm manifestation was diagnosed (Figure 2 [Fig. 2]). Via EIA, Echinococcus multilocularis was identified to cause the disease. Debridement as fare as possible was performed and antihelmentic treatment was started. 11 months later, MRI showed drastic improvement and clinical symptoms – low back pain and hypesthesia – were improved.
Conclusion: Here, we give an example of how difficult it is to diagnose this seldom entity. Clinical symptoms are not specific; MRI changes to us are difficult to judge. Within our patient population up to now, we rarely face this entity. Thus, thinking about the possibility of such a seldom disease seems to be an important step towards correct diagnosis. Patient’s history, profession and unusual MRI changes should raise our suspicion to a seldom disease. Then, repeated biopsies must be done until diagnosis is made so that treatment can be started. It may be anticipated, that this entity could be observed more often due to immigration and globalisation.