Cardiac Hydatid Cyst Rupture and Embolization Causing Lower Limb Ischemia and Multiple Infarcts: A Case Report

Hydatid Cyst (HC) is a complex, chronic parasitic disease with a world-wide distribution. It is endemic in communities where infected meat of grazing animals is consumed by the humans. Those grazing animals acquire parasitic infection by eating grass that is contaminated with dog fecal matter, which contains eggs of parasite that develop into hydatid cyst. HC is caused by the larval stage (daughter cells/ brood capsules) of Echinococcus granulosus found in intermediate host of sheep and human beings. Dog contains adult form of parasite in intestine and is the true host. HC diagnosis is based on serological reactions like Casoni test and ELISA for Echinococcus multilocularis and serves as adjunctive role along with radiological investigations. The diagnosis of cardiac HC is done by echocardiography, X-ray chest, contrast spiral computerized tomography, and/or magnetic resonance imaging. Cardiac hydatid cyst rupture from left heart causing ischemia and distal infarction by multiple emboli is a rare entity. We report such a case of a 24 year young Saudi male who died of Systemic Inflammatory Response Syndrome and Multiple Organ Dysfunction Syndrome, while under treatment for bilateral lower limbs ischemia. Keywords: Ruptured Cardiac HC; Embolism; Lower Limb Vascular Ischemia and Infarction; Systemic Inflammatory Response Syndrome; Multiple Organ Dysfunction Syndrom