Primary hydatid disease of the spine: an unusual cause of progressive paraplegia - Case report and review of the literature

Although rare, spinal hydatid disease is a manifestation of hydatid infesta tion. The authors present the report of a patient who presented with primar y spinal hydatid disease. This disease is often misdiagnosed as tuberculous spondylitis, and thus patients may subsequently receive inappropriate trea tment. The patient in this case presented, with an increasing weakness in the lowe r limbs, to a different clinic from an area in India where hydatid infectio ns are endemic. The infection was misdiagnosed as tuberculous spondolytis b ased on evaluation of plain x-ray films, and the patient underwent antitube rculous chemotherapy and a posterior surgical decompressive procedure. The patient presented to the authors' clinic with increasing paraparesis 1. 5 years later. Radiographs and a magnetic resonance image of the spine were obtained, which strongly suggested hydatid disease. Examination of serum l evels confirmed the diagnosis. The patient underwent a decompressive proced ure of the spine in which stabilization was performed. Postoperatively her paraparesis resolved, and good control over the disease was achieved by che motherapy. The authors conclude that primary spinal hydatid disease of the spine, alth ough a rare manifestation, should be considered in the differential diagnos is in patients with infectious and destructive lesions of the spine in regi ons in which the disease is endemic. Advanced imaging studies should be per formed to diagnose the disease. Early decompressive surgery with stabilizat ion of the spine, in addition to adjuvant chemotherapy, is the treatment of choice for these patients.