An Extremely Rare Case of Cardiac Hydatid Cyst Co-infected with Brevundimonas Nasdae: Diagnostic Challenges and Management

Abstract

Cardiac hydatid cyst (HC) is a rare localisation of hydatidosis. The main preoperative diagnostic tools are serology, Transthoracic Echocardiography (TTE), Cardiac Tomography (CT) and Nuclear Magnetic Resonance Imaging (MRI). MRI is the key examination for diagnosing cardiac masses. It enables anatomical relationships to be studied and a reliable etiological orientation to be made. We report a challenging case of pericardial hydatid cyst associated to a rare infection to Brevundimonas nasdae clinically revealed by chronic dyspnea and atypical acute chest pain evolving in a febrile context. In our case, the HC presented as a cardiac mass, with an atypical appearance on echocardiography suggestive of a rhabdomyosarcoma.  The MRI rectified the diagnosis, which was subsequently confirmed on operative finding, and on anatomo-pathological examination. The Patient was successfully managed after multidisciplinary treatment including combined surgical, antibiotics and antiparasitic treatments.