Hydatid cyst: hepatitis B and D coinfection accelerating the course of the disease

Description

A Romanian man aged 31 years presented to the liver clinic with recurrent right upper quadrant pain. He had moved to the UK a few months prior to his first appointment. His background included chronic e-antigen-negative hepatitis B infection, Child-Pugh A liver cirrhosis with portal hypertension, and a known hydatid cyst for which he had two previous liver resections and 6 months of albendazole.

On further investigation, hydatid serology was confirmed, FibroScan score was 34 and blood tests revealed stable liver function tests, thrombocytopenia, latent syphilis and a hepatitis D coinfection. The latter accounted for his accelerated disease course. Ultrasonography showed a large complex cyst within the right lobe of the liver, splenomegaly and a previous cholecystectomy (figure 1). CT confirmed a viable hydatid cyst (figure 2). There were no extrahepatic manifestations of hydatid disease.

Figure 1

Ultrasound: fatty, coarse liver with a...

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