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Pelvic echinococcosis in a Northern Iraqi refugee.

Travel and tropical medicine practitioners who care for refugee or other geographically displaced populations may encounter patients with hydatidosis or echinococcosis. Human infection with one of the larval forms (metacestode) of one of the four species of Echinococcus (E granulosus, E multilocularis, E vogeli, E oligarthrus) may result in echinococcal disease.1–6 The metacestode stages develop into hydatid cysts by a process unique for each Echinococcus spp. Among these, E granulosus and E multilocularis are responsible for the large majority of human cases. Alveolar echinococcosis or multilocular echinococcosis is caused by E multilocularis . Cystic hydatid disease is an infection caused by E granulosus ,1,2 and polycystic hydatid disease is due to E vogeli or E oligarthrus . The epidemiology, clinical manifestations, natural history of hydatid disease and alveolar echinococcosis are different.1–5 Herein, we describe the case of a Northern Iraqi Refugee who presented with cystic hydatid disease due to E granulosus , with abdominal pain and elevated liver enzymes and multiple liver and pelvic cysts that responded to albendazole therapy. In addition, we briefly review other therapeutic modalities in patients with cystic hydatid disease.

A 64‐year‐old Kurdish refugee from Northern Iraq presented to the hospital with a 3‐week history of postprandial right upper quadrant pain associated with nausea but no vomiting. He denied fever, chills, headache, or other complaints. He was a shepherd in Iraq. He had lived 5 years in the United States and currently works at a local grocery store. He referred to having surgery for the same symptoms in 1979 and in the early 1980s. On physical examination his vital signs were within normal limits. He was in no acute distress, and no jaundice or lymphadenopathy was identified. His skin revealed no rashes. His cardiac and pulmonary examinations were normal. His abdomen revealed the …