Thursday, June 24, 2010

Foxes and Sheep

A 40 year old patient presents with nonspecific malaise, weight loss, and right upper quadrant discomfort. He has hepatomegaly on exam. Labs show a leukopenia, mild eosinophilia, and borderline liver function tests. A CT and fecal smear are shown below.

Surgery is performed and an intraoperative specimen is shown below.

Challenge: What's the diagnosis? Why handle that thing so carefully?
First image shown under Fair Use. Second image is in the public domain. Third image shown under Creative Commons Share-Alike 3.0 License.

3 comments:

tree said...

Echinococcosis - don't rupture the hydatid cysts!! AHHHH!!!!!

Alex said...

echinococcus?

Craig Chen said...

yay!
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Foxes and Sheep

Echinococcus is a tapeworm whose life cycle involves definitive hosts like dogs and foxes and intermediate hosts like sheep; humans are an accidental host. Notably, different species have different presentations; E. granulosus usually has one cyst but can involve different organ systems whereas E. multilocularis may have multiple cysts, usually in the liver. Cyst rupture can lead to fever and anaphylaxis due to a hypersensitivity reaction. Treatment includes albendazole.

Sources: UpToDate; CDC; Wikipedia.