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scoleces are budded off into the lumen or remain attached to the germinative wall (Figure 2
C). The floating scoleces often enlarge, become vesicular, and develop into daughter
floating colonies within the parent cyst. These in turn may bud off a third generation of
cysts within themselves. The result is an enclosed sac containing myriads of future adult
worms ready to infect a dog or other susceptible carnivore that feeds on the hydatid-infected
animal and the scolex-filled cyst fluid (Adamson ML, 1994).
Clinical Manifestations
Echinococcosis (hydatid disease) results from the presence of one or more massive cysts, or
hydatids, which can develop in any tissue site, including the liver, lungs (25%), heart, brain
(1%), kidneys (2%), spleen (1%), tyroid and long bones (3%). Hepatic localization is the
most frequent (63%), because the infestation occurs by digestive way, and liver is the first
filter on this way. Hydatid disease may have any localization. The clinical manifestations of
this infection therefore vary greatly, depending on the site and size of the cyst, but resemble
those of a slow-growing tumor that causes gradually increasing pressure. Infections in the
liver, lungs, or subcutaneous tissue sites may be asymptomatic for many years, but pressure
effects eventually develop. In sensitive or vital areas, hydatids produce a panoply of
symptoms, chiefly owing to mechanical compression or blocking effects but also include
collapse of infected long bones, blindness, and epileptiform seizures. The rupture of a
hydatid cyst may induce sudden anaphylactic shock. Secondary complications may occur as
a result of infection of the cyst or leakage of the cyst. Unilocular cysts are frequently single
(75%). However, they can also have a multifocal or multiorgan localization. The frequency
of multiple localization ranges between 11% and 30% from 2 % to 14%. Lung involvement
is solitary in 70% of the cases, and multiple in 30% Unilocular cysts can remain
asymptomatic for 5-20 years. The diagnosis is established, with few exceptions, by
paraclinical investigations, especially by imaging techniques (ultrasonography, conventional
radiology, computed tomography) as well as by immunological studies (ELISA). Although
drug treatment has been followed by many failed attempts, today we can witness its revival
due to the new drugs (mebendazol, albendazole) which completely destroy the univesicular
hydatid cyst in 50-80% of the cases after 3 months of treatment. Some authors reported a
sterilization rate of 95%. Nevertheless, the treatment of choice remains surgical.
Patients and Methods: We studied a lot of 18 cases with age between 0-69 years,
hospitalized at the Clinical Hospital Infectious Diseases of Oradea, between years 1998-
2006, with a hepatic hydatid cyst, established by clinical and paraclinical data. The study
was performed on: the patients observation files; the biochemical methods (a complete
blood count), the serologic methods (detection of the anti-Echinococcus antibodies with
ELISA method) and imaging techniques (ultrasonography, conventional radiology).
The Epidemiological Particularities:
The Number of cases with Hepatic Hydatid Cyst
From analyzing the annual incidence of the Hepatic Hydatid Cyst (HHC) between years
1998-2006, hospitalized the Clinical Hospital Infectious Diseases of Oradea, we observed
556