Late vertebral and pulmonary alveolar echinococcosis after hepatic surgery mimicking spinal and disseminated tuberculosis: a case report.
Vertebral and pulmonary alveolar echinococcosis emerged 8 years after hepatic hydatid surgery, mimicking tuberculosis.
Late vertebral and pulmonary alveolar echinococcosis after hepatic surgery mimicking spinal and disseminated tuberculosis: a case report.
Alveolar echinococcosis (alveolar echinococcosis) is a rare but potentially fatal zoonotic disease that primarily affects the liver, while extrahepatic involvement usually indicates advanced disease and poor prognosis.
CASE PRESENTATION: A 28-year-old Tibetan woman from a nomadic family presented with a 7-month history of progressive back pain and a 2-month history of cough.
Spinal CT and MRI revealed osteolytic destruction of the T12-L2 vertebrae with paravertebral and psoas abscesses, and chest CT showed diffusely distributed bilateral pulmonary nodules.
Despite standard anti-tuberculosis therapy, vertebral destruction, paravertebral involvement, psoas abscesses, and pulmonary nodules progressed over 12 months.
Follow-up imaging after 3 months showed marked improvement, and the patient's symptoms substantially resolved by 6 months.
This case highlights the striking clinical and radiological resemblance between extrahepatic alveolar echinococcosis and tuberculosis, the risk of diagnostic anchoring in endemic settings, and the diagnostic value of mNGS when conventional investigations are inconclusive.
The 8-year latency after hepatic surgery underscores the chronic, invasive nature of alveolar echinococcosis and the need for lifelong surveillance and multidisciplinary management.