Kseibi, Hala

Abstract Introduction Hydatid disease, caused by the parasite Echinococcus granulosus, is a prevalent parasitic infection found in various regions worldwide, including the Middle East, southern Europe, and Africa. Although hepatic and pulmonary involvements are well-documented, atypical presentations of the disease remain significant. Case Presentation This case report discusses a 32-year-old female patient who sought medical attention due to right hypochondrial pain, and pallor. Initial imaging revealed a hepatic cyst, but an incidental finding of a pericardial cyst further complicated the diagnosis. Subsequent evaluations confirmed the presence of a pericardial hydatid cyst, which is an uncommon manifestation of the disease. The patient presented with a multi-organ infection, which included a cardiac cyst—an unusual occurrence in hydatid disease. Additionally, the pericardial cyst was situated in the pericardium, a rare location, accounting for 2–10% of all cardiac cysts. Importantly, this cyst lacked myocardial involvement, adding to its uniqueness. Conclusion This case underscores the importance of considering hydatid disease in patients with non-specific symptoms, particularly in endemic regions, as timely diagnosis is crucial in preventing severe complications.

Abstract Background Over the past decades, cytomegalovirus has stood out as one of the most common viruses to cause acute infection in kidney transplantation patients, especially during the first six months, noting that the causes of late and very late infection are still not sufficiently studied. Symptoms of cytomegalovirus infection range from asymptomatic to end-organ infection that may cause graft rejection, which makes it an important factor for investigation and further study. Cytomegalovirus infection showed an increase in the morbidity and mortality of patients in addition to life-threatening complications associated with hypercoagulability and deep vein thrombosis, such as pulmonary embolism. Case presentation A65-year-old man with a history of kidney transplant 15 years ago due to idiopathic chronic renal failure, hypertension, diabetes type 2, and ischemic heart disease presented to the emergency department with a complaint of fatigue and hematemesis. His vital signs were normal, and initial tests showed an increase in creatine numbers. An upper gastrointestinal endoscopy was performed, and a biopsy was taken from the superior side of the pylorus, which later revealed signs of chronic gastritis. A cytomegalovirus-polymerase chain reaction was made, which came back positive, and the patient was diagnosed with chronic cytomegalovirus gastritis and treated with ganciclovir. The patient was discharged later with no signs of deep venous thrombosis. Five days after the discharge, the patient was admitted with signs of deep venous thrombosis only in the right lower limb and, after a few days, developed superficial vein thrombosis in his right arm. He was treated for both and left to rest. Conclusion Cytomegalovirus can cause deep venous thrombosis through an unknown mechanism that needs to be studied and analyzed. It is important to note that there is only one case report in the medical literature similar to ours (33) to the best of our knowledge, which makes our case considered to be a very rare case. In addition, CMV infection is a predisposing factor for thrombosis that needs to be considered in kidney transplant patients. Therefore, physicians should be aware of this complication and consider using prophylactic anticoagulants for high-risk patients.