A rare case of recurrent primary spinal echinococcosis
We report a 65 year old man who presented to us with complaints of low backache radiating to left hip for 3 years and urge incontinence for 20 days. Patient had underwent laminectomy with excision of hydatid cysts 13 years back []. Postoperatively patient had received albendazole therapy. On examination, all forms of sensations were decreased bilaterally and symmetrically in the saddle distribution. Motor deficit was not marked but ankle reflex was absent on both sides. Local examination revealed midline scar in lumbosacral region with prominent left paraspinal area. Total blood cell counts, erythrocyte sedimentation rate (ESR), complete biochemical serum, and urine parameters, coagulation tests, ultrasonography abdomen and chest radiograph were within normal ranges. ELISA for Echinococcus granulosus was positive. MRI revealed multiple loculated cystic swelling in left paraspinal area with extension into extradural space at S2 level causing thecal sac compression [Figures and ]. Patient was put on albendazole preoperatively and underwent re-exploration with excision of multiple hydatid cysts in lumbosacral spine [Figures and ]. Histopathological examinations confirmed hydatidosis. Postoperatively patient was put on combination therapy of albendazole and praziquantel. Patient recovered uneventfully with good bladder control and without new deficits.