ZyraDoc #54 - September 24, 2026

A 42-year-old livestock farmer presents with a 6-month history of vague right upper quadrant abdominal discomfort, early satiety, and low-grade fever.

Physical examination reveals non-tender hepatomegaly, while an abdominal ultrasound demonstrates a well-defined, smooth, thick-walled fluid collection in the right liver lobe containing multiple daughter cysts (honeycomb pattern) and hydatid sand.

Echinococcus IgG serology (ELISA) is positive, confirming a diagnosis of hepatic Cystic Echinococcosis (Hydatid Cyst Disease).

Case Summary

Clinical Focus:

The diagnosis is Cystic Echinococcosis (Hydatid Cyst Disease).

Aetiology/Cause:

Infection with the larval stage of the tapeworm Echinococcus granulosus.
Ingestion of microscopic parasite eggs passed in the feces of definitive hosts (dogs/canines) via contaminated water, food, or direct contact.
Intermediate host cycle in sheep/livestock, with human accidental dead-end infection leading to slow-growing oncosphere encystment primarily in the liver (70%) and lungs (20%).

Clinical Features:

Often asymptomatic for years or decades due to slow cyst growth.
Right upper quadrant abdominal pain, palpable hepatomegaly, and abdominal distension.
Cholestatic jaundice, biliary colic, or recurrent cholangitis if the cyst compresses or ruptures into biliary ducts.
Pulmonary manifestations (cough, hemoptysis, chest pain) if localized in the lung.

Diagnosis and Investigations:

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