Echinococcosis of the lung and pregnancy

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Abstract

Background: Echinococcosis is a parasitic disease caused by the larvae of tapeworms. In the gastrointestinal tract of intermediate hosts, which are herbivores and humans, oncospheres are released, hematogenically spreading through the systemic circulation and most frequently affecting the liver (44–85%) and lung (15–20%). The clinical symptoms of human echinococcosis depend on the site and size of cysts. Instrumental diagnosis is based on the use of various imaging methods. A decrease in cellular immunity and a rise in the concentration of steroid hormones during pregnancy lead to a significant increase in echinococcal cysts, which is often complicated by their rupture.

Case report: A 36-year-old repeatedly pregnant woman at 30 weeks’ gestation was taken to an obstetric hospital with complaints of paroxysmal cough and a feeling of lack of air with an oxygen saturation level of 94%. When examining the patient, the physicians found tachypnea, tachycardia, and progressive dyspnea. Blood tests detected hypoxemia, hypocapnia, and elevated C-reactive protein levels. Chest computed tomography revealed rounded masses in the lower lobes of the both lungs with a layered capsule and subcapsular arrangement of gas bubbles corresponding to the presence of parasitic cysts. A decision was made to surgically remove the masses with a preliminary early delivery of the patient. The histological examination data confirmed the echinococcal genesis of lung damage.

Conclusion: In the third trimester of pregnancy, rapid uterine growth rates associated with higher intraabdominal pressure and with the upward displacement of the diaphragm are a high risk factor for parasitic cyst rupture, which poses a threat to the life of the mother and her fetus due to the development of an anaphylactic reaction. Since surgical removal of cysts on during prolonged pregnancy also creates a risk of their rupture; at the first stage, the patient was prematurely delivered via cesarean section. Owing to the coordinated interaction of specialists of various profiles, the maternal and perinatal outcomes turned out to be favorable.

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About the authors

Irina V. Ignatko

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: ignatko_i_v@staff.sechenov.ru

Dr. Med. Sci., Corresponding Member of the Russian Academy of Sciences, Professor of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics, Gynecology and Perinatology, N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

Irina M. Bogomazova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: bogomazova_i_m@staff.sechenov.ru
ORCID iD: 0000-0003-1156-7726

PhD, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology, N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

Elena V. Timokhina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: timokhina_i_m@staff.sechenov.ru

Dr. Med. Sci., Associate Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology, N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

Vera S. Belousova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: belousova_v_s@staff.sechenov.ru

Dr. Med. Sci., Associate Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology, N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

Elena L. Muravina

S.S. Yudin City Clinical Hospital, Moscow City Healthcare Department

Email: gkb-yudina@zdrav.mos.ru

PhD, Deputy Chief Physician for Obstetrics and Gynecology

Russian Federation, Moscow

Yulia A. Samoylova

S.S. Yudin City Clinical Hospital, Moscow City Healthcare Department

Email: gkb-yudina@zdrav.mos.ru

PhD, Head of the Department of Pregnancy Pathology №1 of the Maternity Hospital

Russian Federation, Moscow

Tatyana V. Rasskazova

S.S. Yudin City Clinical Hospital, Moscow City Healthcare Department

Email: gkb-yudina@zdrav.mos.ru

obstetrician-gynecologist of the Department of Pregnancy Pathology №1 of the Maternity Hospital

Russian Federation, Moscow

Georgy O. Zayratyants

S.S. Yudin City Clinical Hospital, Moscow City Healthcare Department; A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation

Email: gkb-yudina@zdrav.mos.ru

PhD, Head of the Pathology Department; Associate Professor of the Department of Pathological Anatomy of the Medical Faculty

Russian Federation, Moscow; Moscow

Azaliya N. Salakhutdinova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: calaxutdinova@yandex.ru

student of the N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

References

  1. Agudelo Higuita N.I., Brunetti E., McCloskey C. Cystic echinococcosis. J. Clin. Microbiol. 2016; 54(3): 518-23. https//dx.doi.org/10.1128/JCM.02420-15.
  2. Al-Ani A., Elzouki A.N., Mazhar R. An imported case of echinococcosis in a pregnant lady with unusual presentation. Case Rep. Infect. Dis. 2013; 2013: 753848. https//dx.doi.org/10.1155/2013/753848.
  3. https://58.rospotrebnadzor.ru/rss_all//asset_publisher/Kq6J/content/id/34821
  4. Kapatia G., Tom J.P., Rohilla M., Gupta P., Gupta N., Srinivasan R. et al. The clinical and cytomorphological spectrum of hydatid disease. Diagn. Cytopathol. 2020; 48(6): 547-53. https//dx.doi.org/10.1002/dc.24391.
  5. Nabarro L.E., Amin Z., Chiodini P.L. Current management of cystic echinococcosis: a survey of specialist practice. Clin. Infect. Dis. 2015; 60(5): 721-8. https//dx.doi.org/10.1093/cid/ciu931.
  6. Arslan B., Sonmez O. Diagnosis of a ruptured pulmonary hydatid cyst in a 26-week pregnant female with Bedside Lung Ultrasound in Emergency (BLUE) protocol: a case report. Cureus. 2022; 14(5): e25431. https//dx.doi.org/10.7759/cureus.25431.
  7. Llanos O., Lee S., Salinas J.L., Sanchez R. A 28-Year-old pregnant woman with a lung abscess and complicated pleural effusion. Chest. 2020; 158(5): e233-e236. https//dx.doi.org/10.1016/j.chest.2020.07.008.
  8. Salih A.M., Ahmed D.M., Kakamad F.H., Essa R.A., Hunar A.H., Ali H.M. Primary chest wall Hydatid cyst: review of literature with report of a new case. Int. J. Surg. Case Rep. 2017; 41: 404-6. https//dx.doi.org/10.1016/ j.ijscr.2017.10.051.
  9. Hijazi M.H., Al-Ansari M.A. Pulmonary hydatid cyst in a pregnant patient causing acute respiratory failure. Ann. Thorac. Med. 2007; 2(2): 66-8. https//dx.doi.org/10.4103/1817-1737.32234.
  10. Тумольская Н.И., Голованова Н.Ю., Мазманян М.В., Завойкин В.Д. Клинические маски паразитарных болезней. Инфекционные болезни: новости, мнения, обучения. 2014; 1: 17-27. [Tumolskaya N.I., Golovanova N.Yu., Mazmanyan M.V., Zavoykin V.D. The clinical masks of parasitic diseases. Infectious Diseases: News, Opinions, Training. 2014; (1): 17-27. (in Russian)].
  11. Rostami A., Keykhali N., Broujerdi G. Heart and lung hydatid cyst in a pregnant woman: a case report. Ann. Med. Health Sci. Res. 2017; 7: 373-6.
  12. Демидов В.Н., Саркисов С.Э., Демидов А.В. Брюшная беременность – клиника, диагностика, исходы. Акушерство и гинекология. 2014; 12: 94-9. [Demidov V.N., Sarkisov S.E., Demidov A.V. Abdominal pregnancy: Clinical picture, diagnosis, outcomes. Obstetrics and Gynecology. 2014; (12): 94-9 (in Russian)].
  13. Poiat C., Sivaci R., Baki E., Kosar M.N., Yiimaz S., Arikan Y. Recurrent hepatic hydatid cyst in a pregnant woman. Med. Sci. Monit. 2007; 13(2): CS27-29.
  14. Шевченко Ю.Л., Назиров Ф.Г., Аблицов Ю.А., Худайбергенов Ш.М., Мусаев Г.Х., Василашко В.И., Аблицов А.Ю. Хирургическое лечение эхинококкоза легких. Вестник Национального медико-хирургического Центра им. Н.И. Пирогова. 2016; 11(3): 14-23. [Shevchenko Yu.L., Nazirov F.G., Ablicov Yu.A., Hudajbergenov Sh.M., Musaev G.H., Vasilashko V., Ablicov A.Yu. Surgical treatment of pulmonary hydratid cyst. Bulletin of the National Medical and Surgical Center named after N.I. Pirogov. 2016; 11(3): 14-23. (in Russian)].
  15. Azlin M.Y., Esa H.A.H., Hameed A.A., Wahid W., Pakeer O. First case of pulmonary hydatid cyst in a pregnant Syrian refugee woman in Malaysia. Med. J. Malaysia. 2021; 76(1): 103-6.
  16. Мусаев Г.К., Шарипов Р.К., Фатянова А.С., Левкин В.В., Ищенко А.И., Зуев В.М. Эхинококкоз и беременность: подходы к тактике лечения. Хирургия. Журнал им. Н.И. Пирогова. 2019; 5: 38-41. [Musaev G.K., Sharipov R.K., Fatyanova A.S., Levkin V.V., Ishchenko A.I., Zuyev VM. Echinococcosis and pregnancy: approaches to the treatment. Pirogov Russian Journal of Surgery. 2019; (5): 38-41. (in Russian)]. https//dx.doi.org/10.17116/hirurgia201905138.
  17. Наумов Д.Г., Вишневский А.А., Ткач С.Г., Аветисян А.О. Эхинококковое поражение шейно-грудного отдела позвоночника у беременной: клинический случай и обзор литературы. Травматология и ортопедия России. 2021; 27(4): 102-10. [Naumov D.G., Vishnevsky A.A., Tkach S.G., Avetisyan A.O. Spinal hydatid disease of cervico-thoracic in pregnant women: a case report and review. Traumatology and Orthopedics of Russia. 2021; 27(4): 102-10. (in Russian)]. First case of pulmonary hydatid cyst in a pregnant Syrian refugee woman in Malaysia 10/21823/2311-2905-1668.
  18. Тоноян Н.М., Козаченко И.Ф., Франкевич В.Е., Чаговец В.В., Адамян Л.В. Рецидивы миомы матки. Современный взгляд на проблемы диагностики, лечения и прогнозирования. Акушерство и гинекология. 2019; 3: 32-38. [Tonoyan N.M., Kozachenko I.F., Frankevich V.E., Chagovets V.V., Adamyan L.V. Recurrences of uterine fibroids. The modern view on the problems of diagnosis, treatment, and prognosis. Obstetrics and Gynecology. 2019; (3): 32-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.3.32-38.
  19. Кюрдзиди С.О., Хащенко Е.П., Уварова Е.В., Чупрынин В.Д., Асатурова А.В., Трегубова А.В. Гигантская фолликулярная киста у девочки-подростка. Акушерство и гинекология. 2020; 8: 187-93. [Kyurdzidi S.O., Hashchenko E.P., Uvarova E.V., Chuprynin V.D., Asaturova A.V., Tregubova A.V. Giant follicular cyst in a teenage girl. Obstetrics and Gynecology. 2020; (8): 187-93 (in Russian)]. https://dx.doi.org/10.18565/ aig.2020.8.187-193.
  20. Thakare P.Y. Hydatid cysts in a pregnant uterus. J. Obstet. Gynaecol. India. 2014; 64(3): 215-7. https://dx.doi.org/10.1007/s13224-012-0276-z.
  21. Рымашевский А.Н., Черкасов М.Ф., Волков А.Е., Волошин В.В., Келлер О.В., Гусева Н.П. Паразитарная атака на беременность. Опыт хирургического лечения эхинококоза печени в 23 нед гестации. StatusPraesens. Гинекология, акушерство, бесплодный брак. 2019; 6: 87-92. [Rymashevskij A.N., Cherkasov M.F., Volkov A.E., Voloshin V.V., Keller O.V., Guseva N.P. Parasitic attack on pregnancy. Experience of surgical treatment of liver echinococcosis at 23 weeks of gestation. StatusPraesens. Ginekologiya, Akusherstvo, Besplodnyj Brak. 2019; (6): 87-92. (in Russian)].
  22. Li P., Wang Y., Yang Q., Ni M., Fan J., Huang Z. Management of breech presentation with a large pelvic hydatid cyst in late pregnancy in Tibet: a case report. BMC Pregnancy Childbirth. 2022; 22(1): 858. https//dx.doi.org/10.1186/s12884-022-05180-2.

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