Hydatidosis of Tibia

A 71 year old female from a village was admitted to Ahwaz Imam Khomeini hospital in southwestern part 7 years ago with pain and swelling at the upper and middle third of right tibia. Operation was performed and permanent sinus secretion of the midportion occurred. After 7 years the patient returned to hospital recently with warmness, swelling and edema and sinus secretion in middle and upper of right leg. Radiological examination revealed osteolytic metaphyseal and diaplyseal lesion with honey combs appearance transitional zone was narrow without reactive bone and incomplete fractures were also noted. Abdominal sonography was normal. Wound discharge culture indicated Klebsiella, Proteus and E.coli. After antibiotic therapy the patient was put under general anesthesia and complete excision of middle part of tibia from proximal metaphysic to distal metaphysis was performed. During the operation laminated layers and daughter cysts of hydatid cysts were seen. The lesion was washed with 0.5% of NO3Ag and 3cm under the tibia plateau to 7cm of tibia planoid was debrided and cement spacer was used for filling the spaces. Histopathologic examination of the resected specimen confirmed the hydatid cyst. The patient was prescribed albendazole and discharged from the hospital. She is being followed up now.