A case of Echinococcus granulosus hepatic hydatid cyst together with pyogenic liver abscess in a Nepali patient

Hydatidic disease (echinococcosis) is a significant health problem in Nepal. In humans, mainly involves liver and commonly remains silent without symptoms or causing only mild pressure symptomatology. However, inadequate invasive medical procedures may cause the rupture of the cyst with serious complications, anaphylactic shock and death. Herein, we report the case of a Nepali patient who had been treated of a hepatic abscess with percutaneous drainage and antibiotics in a previous hospitalization. Study by drain fluid, ultrasonography and the magnetic resonance imaging revealed the presence of an intact Hydatidic cyst in the liver concomitantly with a percutaneously draining abscess (with free hooklets and a drain tube). This emphasizes the importance of putting the Hydatidic cyst into the differential diagnosis of liver abscess, especially in non-endemic areas.