Abstract
INTRODUCTION: Hydatid disease (HD) is an endemic zoonotic parasitic infection caused by Echinococcus granulosus. The incidence of HD in the musculoskeletal system and soft tissues is extremely rare, ranging from 0.5% to 4.7%.
CASE REPORT: We present a rare case of primary intramuscular hydatid disease in an agricultural worker, diagnosed through clinical evaluation, serological testing, and imaging, and managed with surgical intervention.
DISCUSSION: Hydatid disease is primarily transmitted through ingestion of eggs, leading to infection by the larval form of Echinococcus. While other transmission modes have been suggested, they lack strong evidence. Hydatid cysts most commonly affect the liver and lungs, but can rarely develop in muscles, which generally provide an unfavourable environment due to high lactic acid levels and muscle contractility. Intramuscular hydatid cysts, particularly in the upper limbs, are especially uncommon, likely due to constant muscle activity in this region.
Ultrasound, MRI, and serological tests are crucial diagnostic tools, with MRI being particularly useful for intramuscular cases. Surgical excision is the primary treatment, with pre- and post-operative anthelmintic therapy reducing recurrence rates.
CONCLUSION: Clinicians should maintain a high index of suspicion for hydatidosis in patients from endemic regions, particularly those with an agricultural background, when assessing musculoskeletal swellings. Early detection ensures timely management.