A Case of Pulmonary and Hepatic Cystic Echinococcosis of CE1 Stage in a Healthy Japanese Female that Was Suspected to Have Been Acquired During Her Stay in the United Kingdom

Kiwamu Nakamura Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Akira Ito Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Satomi Yara Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Shusaku Haranaga Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Kenji Hibiya Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Tsuneo Hirayasu Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Yasuhito Sako Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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Jiro Fujita Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan; Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan; Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan

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We herein report a case of a young Japanese female who was confirmed to have cystic echinococcosis (CE) 1 stage based on the World Health Organization Informal Working Group on Echinococcosis pathological classification of CE, and she was also suspected to be infected with eggs of the G1 Echinococcus granulosus sensu stricto during her stay in the United Kingdom and therefore, suffered from synchronous pulmonary and hepatic CE. Oral albendazole was administered initially, but rupture of a lung hydatid cyst was observed. To avoid additional rupture, we performed two surgeries. CE is very rare in Japan; all CE cases in Japan during the past two decades have been confirmed to be imported, and almost all cases are hepatic CE. This case is the first case report of a Japanese patient who had concomitant giant lung and liver CE with early-stage CE1 and was successfully treated by surgery and pharmacotherapy with a serological follow-up.

Author Notes

*Address correspondence to Kiwamu Nakamura, Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. E-mail: kiwamu1204@hotmail.com
†These authors contributed equally.

Financial support: Serological and molecular studies on this case report were supported by Grant-in-Aid 21256003 for Scientific Research from the Japan Society for Promotion of Science (JSPS) and the Special Coordination Funds for Promoting Science and Technology (MEXT; to A.I.).

Authors' addresses: Kiwamu Nakamura, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, E-mail: kiwamu1204@hotmail.com. Akira Ito and Yasuhito Sako, Department of Parasitology, Asahikawa Medical University, Midorigaoka Higashi, Asahikawa, Hokkaido, Japan, E-mails: akiraito@asahikawa-med.ac.jp and yasusako@asahikawa-med.ac.jp. Satomi Yara, Shusaku Haranaga, Kenji Hibiya, and Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan, E-mails: f040621@med.u-ryukyu.ac.jp, f014936@med.u-ryukyu.ac.jp, kenjihibiya@gmail.com, and fujita@med.u-ryukyu.ac.jp. Tsuneo Hirayasu, Division of Thoracic and Cardiovascular Surgery, Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan, E-mail: t7696713h@yahoo.co.jp.

Reprint requests: Kiwamu Nakamura, University of Texas Medical Branch, Department of Internal Medicine, 301 University Boulevard, Galveston, TX 77555-0435, E-mail: kiwamu1204@hotmail.com.

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