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Journal of Medical Case Reports

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Open Access 01-12-2021 | Nephrectomy | Case report

Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report

Authors: Sameera Shuaibi, Abdelrahman AlAshqar, Munirah Alabdulhadi, Wasl Al-Adsani

Published in: Journal of Medical Case Reports | Issue 1/2021

Abstract

Introduction

Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present a patient with renal echinococcosis treated successfully with exclusive antiparasitic pharmacotherapy after refusing surgery despite extensive renal involvement. We hope through this report to help establish future solid guidelines regarding this uncommon therapeutic approach.

Case presentation

This is a case of a 49-year-old Syrian shepherd presenting with flank pain and passage of grape-skin-like structures in urine. A diagnosis of renal echinococcosis with hydatiduria and significant parenchymal destruction was established based on exposure history, positive serology, imaging findings, and renal scintigraphy. After proper counseling, the patient refused nephrectomy and was therefore started on dual pharmacotherapy (albendazole and praziquantel) and is having an uneventful follow-up and a satisfactory response to treatment.

Conclusion

This case embodies the daily challenges physicians navigate as they uphold the ethical principles of their practice and support their patients’ autonomy while delivering the best standards of care and consulting the scientific evidence. Although surgery is the cornerstone of renal echinococcosis treatment, treating physicians should be prepared to tackle situations where surgery cannot be done and offer the best next available option for patients who refuse surgery. As data on exclusive pharmacotherapy are limited, future research should thoroughly investigate the efficacy of this uncommon approach and outline reliable recommendations, facilitating future clinical decision-making in this avenue.

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Title: Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report
Authors: Sameera Shuaibi
Abdelrahman AlAshqar
Munirah Alabdulhadi
Wasl Al-Adsani
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Nephrectomy
Echinococcosis
Nephrectomy
Albendazole
Praziquantel
Nephrectomy
Published in: Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-021-02992-2

At a glance: The STEP trials

Springer Medicine

Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report

Abstract

Introduction

Case presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusion

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