Hepatic Cystic Echinococcosis with Abscess Formation: A Rare Case Report from Vietnam

Abstract

Larval forms of Echinococcus tapeworm infection (Cystic Echinococcosis - CE) are a zoonosis of major public health relevance. While prevalent in many Asian countries, it is rarely reported in Vietnam. We present a case of a 73-year-old male farmer from rural Bac Ninh Province with a history of close contact with dogs and consumption of raw vegetables. Originally diagnosed with an asymptomatic 40-mm simple hepatic cyst in 2020, he presented in 2025 with high fever and subcostal pain. Imaging (US/CT) and ELISA serology confirmed a suppurated Echinococcus sp. cyst (WHO stage CE3a). Notably, laboratory results showed a significant systemic inflammatory response with unusual lymphocytosis. The patient underwent a successful partial left hepatectomy and received adjuvant albendazole therapy. This case underscores the necessity of considering CE in the differential diagnosis of hepatic cysts in non-endemic regions like Vietnam, especially when complicated by abscess formation.