[Vertebral hydatidosis with extra- and intra-rachidian hydatid ossifluent pseudoabscess].
A clinical case of a 35-year-old male with antecedents of frequent dog contacts suffering a progressive spastic paraparesis and pains of the low dorsal column is presented. Radiographies of the spinal column showed absence + of D6 right pedicle and a mass in the vicinities. A dorsal spinal column computed axial tomography revealed a retropleural mass close to D6-D7 invading the epidural space and compressing the spinal cord. An indirect hemagglutination test for hydatidosis resulted positive. Laminectomy of D5-D6-D7 and extraction of hydatic vesicles from the epidural space were performed. The patient had an excellent evolution, but four months later symptomatology reappeared with paraplegia. A new laminectomy of D8-D9, also with extraction of hydatic vesicles were carried out. As paraplegia persisted, another laminectomy of D3-D4 and D5 with extraction of additional hydatic elements was executed. Fifteen days later thoracotomy permitted to extirpate an osifluent hydatic abscess. Finally, 18 months after the onset of the illness, laminectomy of D1-D2 with extirpation of hydatic vesicles were performed. The patient was submitted to physiotherapy and rehabilitation. At present he needs a wheel chair. The characteristics of vertebral hydatidosis are commented and the frequent erroneous concepts on the parasitology and clinics of the disease are stressed.
Sapunar
J
J
Departamento de Medicina, Hospital Clínico de la Universidad de Chile.
Gambini
L
L
D000038:Abscess / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D004443:Echinococcosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006386:Hemagglutination Tests; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D013122:Spinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
Hidatidosis vertebral con pseudoabsceso osifluente hidatídico extra e intrarraquídeo.