Manejo diagnóstico y terapéutico de la hidatidosis renal

Abstract

OBJECTIVE: Renal hydatidosis is caused by Echinococcus granulosus and is extremely rare, accounting for 3-4% of the cases of hydatidosis, being the third site after liver and lungs. It generally remains asymptomatic for years and the most frequent symptoms are pain, feeling of flank heaviness, and dysuria. In front of a compatible clinical picture, we studied the diagnostic, therapeutic, and follow-up schemes reviewing the literature. METHODS: We performed an electronic bibliographic search in PubMed (MEDLINE) which MESH terms "Echinococcosis"[MeSH] AND "urinary tract"[MeSH] and bibliographic citations. We perform a review on epidemiology, vital cycle of the parasite and management of patients with hydatidosis. Most published papers correspond to case reports from different localisations, although we found some reviews. RESULTS: We found a total of 137 papers, we selected 23 of them because they were related; five were reviews, but we only include 10 of them in our references. Although most were case reports, the reviews analyse the cycle of the Echinococcus and its various host sites (organs) in the human host. The human being may become an intermediary host through contact with the definitive host (dogs) or by taking contaminated water or vegetables. CONCLUSIONS: Thanks to the combination of history, imaging tests and serology we get close to the diagnosis in up to 80%. In many cases conservative surgery is possible, but after suspicion we should always sterilise with albendazole before surgical treatment, and monitor serum titles of anti- Echinococcus antibodies.