Discussion:
Echinococcosis is a disease caused by infection with parasites of the
Echinococcus genus, which can form cysts primarily in the liver and
lungs. In most cases, the diagnosis of echinococcosis can be relatively
straightforward, but there are situations where the presence of other
conditions can complicate the clinical picture.
In the case described in the report, the presence of polycystic disease,
characterized by the formation of multiple cysts, masked the true nature
of the hepatic cysts for a prolonged period. However, when the patient
developed severe septic episodes, with a significant deterioration in
their general condition, sepsis made the diagnosis more complex.
The negativization of specific indicators of Echinococcus infection may
have been influenced by the presence of sepsis. In these complex
situations, a multidisciplinary approach involving radiologists,
infectious disease specialists, and surgeons is essential to reach an
accurate diagnosis. In some cases, surgical exploration and drainage of
the lesions may be necessary to confirm the presence of echinococcosis.
The possibility of concurrent Echinococcus infection should be
considered in cases where there is polycystic disease with the presence
of cysts exhibiting atypical features in the overall context.
Multidisciplinary evaluation is crucial for making appropriate decisions
regarding pharmacological therapy or invasive treatment, such as surgery
or PAIR (puncture, aspiration, injection, re-aspiration), depending on
the specific circumstances of the patient.