Osseous hydatidosis of the proximal femur: a rare diagnosis in revision total hip arthroplasty

Musculoskeletal hydatidosis is a rare but severe disease in central Europe. This case report presents the incidental finding of an osseous hydatidosis after cementless revision total hip arthroplasty in a patient without a preoperative history of hydatidosis or any clinical symptoms. Revision total...

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Bibliographic Details
Published in:Infection 2019-04, Vol.47 (2), p.301-305
Main Authors: Fröschen, Frank S., Fischer, H. P., Hischebeth, G. T., Reiter-Owona, I., Randau, T. M., Gravius, S., Gravius, N.
Format: Article
Language:English
Subjects:
Adolescent
Albendazole
Albendazole - therapeutic use
Algeria
Anticestodal Agents - therapeutic use
Arthroplasty, Replacement, Hip
Biocompatibility
Biomedical materials
Bone Diseases - diagnosis
Bone Diseases - parasitology
Bone Diseases - surgery
Case Report
Case reports
Chemotherapy
Cysts
Diagnosis
Echinococcosis - diagnosis
Echinococcosis - parasitology
Echinococcosis - surgery
Family Medicine
Femur
Femur - injuries
Femur - parasitology
General Practice
Germany
Hip
Humans
Infectious Diseases
Internal Medicine
Joint surgery
Magnetic resonance imaging
Male
Medical diagnosis
Medicine
Medicine & Public Health
Migration
Osteonecrosis
Osteosynthesis
Parasites
Reoperation
Surgical implants
Total hip arthroplasty
Treatment Outcome
Trochanter
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Description
Summary:Musculoskeletal hydatidosis is a rare but severe disease in central Europe. This case report presents the incidental finding of an osseous hydatidosis after cementless revision total hip arthroplasty in a patient without a preoperative history of hydatidosis or any clinical symptoms. Revision total hip arthroplasty had been necessary due to a septic osteonecrosis of the femoral head 2 years after osteosynthesis of a traumatic proximal femur fracture with a sliding hip screw. The positive sample was taken out of the greater trochanter in the area of the possible former entry point for the lag screw, which was macroscopic inconspicuous. Sero-analysis could afterwards confirm the suspected diagnosis. Postoperative chemotherapy with albendazole was performed for 6 months. A full-body MRI did not reveal any further cysts. This case demonstrates a possible impact of migration on the expected pathogens in revision arthroplasty. This demonstrates that in revision arthroplasty, an infection with this parasite also has to be taken into account, if the patients come from an area endemic for hydatidosis.
ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-018-1193-6