Rare operation saves woman's life

Rare operation saves woman's life

Preetu Nair, TNN

PANAJI: Lying in the ICU of the Campal clinic, Jamila Bi, 62, is a relieved woman. Doctors on April 15 successfully removed a giant sized "hydatid cyst" with thousands of worm eggs from her right lung.

A startling size and rare condition in India, previously unrecorded in medical corridors, doctors revealed that the Ponda-based Jamila, a housewife, might have been living in this condition since her childhood. She was promptly and efficiently diagnosed and referred to the hospital by the TB and Chest government hospital in a critical condition.

"I had frequent cough. But I never took it seriously as it was treated with medicines. In the last two or three years, the problem increased and at times I would cough continuously for nearly 15 to 20 minutes. But then felt better after taking medicines. But since last few months, the cough was unbearable. That's when I was referred by a local physician to TB and chest hospital," recalls Jamila.

"It was a 15 cm diameter giant hydatid cyst within the right lung. Termed the multilocular hydatid, it is formed by worms called echinococcus multiloculare. In India, this problem is rare", said cardiothoracic and vascular surgeon Dr Irineu A Pereira, who operated on Jamila.

While unilocular (single cyst cavity) due to echinococcus granulosus worms are relatively common in India, multilocular hydatid due to echinococcus multiloculare worms is uncommon, said doctors. "Multilocular hydatid in the lung and of this size is rare. There is only 5 to 15 % incidence world wide", said Goa Medical College and hospital's pathology department head Dr Wiseman Pinto, to whom the cyst has been sent for hysto-pathology tests.

Even the WHO manual on echinococcosis in humans and animals states that echinococcus multilocularis has an extensive geographic range in the northern hemisphere, including endemic regions in central Europe, most of northern and central Eurasia and parts of North America. In Eurasia, parts of Turkey, Iran and possibly northern India (report of one human case), the manual reports. "It is dangerous because they typically remain asymptomatic until the cysts cause a mass effect on an organ, which can occur 5-20 years after the initial infestation in the lung, mostly in childhood", said Dr Pereira.

Jamila underwent a three-hour-long surgery, in which her lung was cut open and the cyst removed. "The cyst contained thousands of worms and toxic fluids and had to be extracted without rupturing them, as leak or rupture had huge risk of massive allergic reactions leading to death," explained Dr Pereira.

Doctors said that echinococcus multilocularis worms follow a cyclical route. It is found in sheep and canines. The infection is passed to humans by either eating the infected animal or by drinking water contaminated with the excreta of the infected animal. Though the eggs multiply in the human body, it doesn't grow to become a worm within the human body, added doctors.

19 Apr 2009, The Times of India, Goa edition