An alluring case of an infected hepatic hydatid cyst: A case report

Introduction and importance: Hydatid cyst is a tapeworm infection that most commonly involves the liver and lungs. Other organs that have been found to be involved are the brain, heart, and bones. Humans are accidental, intermediate hosts and become infected after ingesting the eggs of the parasite. The rupture of the cyst can lead to infection which can subsequently lead to the development of an abscess causing complications like peritonitis. Case presentation: Here we present a case of a 48-year-old female who was known case of hypertension and diabetes, on medication presented with complaints of an irreducible mass in the right hypochondriac region for 6 months associated with a dull aching type of pain for 3 days with associated fever. Imaging revealed the presence of an intact cyst that was suspected to be a hydatid cyst. The patient was taken up for a pericystectomy during which the cyst was found to be infected based on purulent contents and culture of the contents. Clinical discussion: Hydatid cyst consists of an endocyst and a pericyst. Hence, infection of the cyst is a rare phenomenon and is seen in immunocompromised patients. The presence of an intact cyst seen both intraoperatively and on imaging makes this case a rare occurrence. Conclusion: Infection of a hydatid cyst is a complication, difficult to diagnose on imaging. Early surgical intervention like incision and drainage of the abscess followed by pericystectomy should be performed, following which appropriate antimicrobial therapy should be started.