Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report
Abstract Introduction Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-021-02992-2 |
| _version_ | 1818885419178131456 |
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| author | Sameera Shuaibi Abdelrahman AlAshqar Munirah Alabdulhadi Wasl Al-Adsani |
| author_facet | Sameera Shuaibi Abdelrahman AlAshqar Munirah Alabdulhadi Wasl Al-Adsani |
| author_sort | Sameera Shuaibi |
| collection | DOAJ |
| description | Abstract Introduction Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present a patient with renal echinococcosis treated successfully with exclusive antiparasitic pharmacotherapy after refusing surgery despite extensive renal involvement. We hope through this report to help establish future solid guidelines regarding this uncommon therapeutic approach. Case presentation This is a case of a 49-year-old Syrian shepherd presenting with flank pain and passage of grape-skin-like structures in urine. A diagnosis of renal echinococcosis with hydatiduria and significant parenchymal destruction was established based on exposure history, positive serology, imaging findings, and renal scintigraphy. After proper counseling, the patient refused nephrectomy and was therefore started on dual pharmacotherapy (albendazole and praziquantel) and is having an uneventful follow-up and a satisfactory response to treatment. Conclusion This case embodies the daily challenges physicians navigate as they uphold the ethical principles of their practice and support their patients’ autonomy while delivering the best standards of care and consulting the scientific evidence. Although surgery is the cornerstone of renal echinococcosis treatment, treating physicians should be prepared to tackle situations where surgery cannot be done and offer the best next available option for patients who refuse surgery. As data on exclusive pharmacotherapy are limited, future research should thoroughly investigate the efficacy of this uncommon approach and outline reliable recommendations, facilitating future clinical decision-making in this avenue. |
| first_indexed | 2024-12-19T16:05:08Z |
| format | Article |
| id | doaj.art-dc68f145f2f54e5aa985764c42a57b1c |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-19T16:05:08Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-dc68f145f2f54e5aa985764c42a57b1c2022-12-21T20:14:51ZengBMCJournal of Medical Case Reports1752-19472021-09-011511810.1186/s13256-021-02992-2Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case reportSameera Shuaibi0Abdelrahman AlAshqar1Munirah Alabdulhadi2Wasl Al-Adsani3Department of Internal Medicine, Al-Amiri HospitalDepartment of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of MedicineMubarak Al-Kabeer HospitalDepartment of Internal Medicine, Mubarak Al-Kabeer HospitalAbstract Introduction Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present a patient with renal echinococcosis treated successfully with exclusive antiparasitic pharmacotherapy after refusing surgery despite extensive renal involvement. We hope through this report to help establish future solid guidelines regarding this uncommon therapeutic approach. Case presentation This is a case of a 49-year-old Syrian shepherd presenting with flank pain and passage of grape-skin-like structures in urine. A diagnosis of renal echinococcosis with hydatiduria and significant parenchymal destruction was established based on exposure history, positive serology, imaging findings, and renal scintigraphy. After proper counseling, the patient refused nephrectomy and was therefore started on dual pharmacotherapy (albendazole and praziquantel) and is having an uneventful follow-up and a satisfactory response to treatment. Conclusion This case embodies the daily challenges physicians navigate as they uphold the ethical principles of their practice and support their patients’ autonomy while delivering the best standards of care and consulting the scientific evidence. Although surgery is the cornerstone of renal echinococcosis treatment, treating physicians should be prepared to tackle situations where surgery cannot be done and offer the best next available option for patients who refuse surgery. As data on exclusive pharmacotherapy are limited, future research should thoroughly investigate the efficacy of this uncommon approach and outline reliable recommendations, facilitating future clinical decision-making in this avenue.https://doi.org/10.1186/s13256-021-02992-2AlbendazoleCase reportHydatid cystHydatiduriaRenal echinococcosis |
| spellingShingle | Sameera Shuaibi Abdelrahman AlAshqar Munirah Alabdulhadi Wasl Al-Adsani Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report Journal of Medical Case Reports Albendazole Case report Hydatid cyst Hydatiduria Renal echinococcosis |
| title | Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report |
| title_full | Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report |
| title_fullStr | Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report |
| title_full_unstemmed | Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report |
| title_short | Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report |
| title_sort | challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney a case report |
| topic | Albendazole Case report Hydatid cyst Hydatiduria Renal echinococcosis |
| url | https://doi.org/10.1186/s13256-021-02992-2 |
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