In a case of serious medical error, an 18-year-old man was treated for six months for tuberculosis (TB) when he actually had a parasitic infection in the lungs, possibly contracted through contact with a stray dog. The patient had a persistent cough and fatigue, which are commonly considered symptoms of TB. Based on these symptoms, doctors put him on TB medicines.
When his condition did not improve, tests conducted at Gurgaon’s CK Birla Hospital revealed that the real cause was hydatid disease, an infection that spreads from animals to humans and is caused by the tapeworm Echinococcus granulosus.
The Times of India quoted, Dr Vikas Mittal, director, department of pulmonology, CK Birla Hospital, saying, “This case is not as unusual as it sounds. Infections that spread from animals, such as hydatid disease, can often show symptoms of diseases like TB. If doctors do not consider these possibilities, misdiagnosis can occur and the patient may have to endure unnecessary treatment.”
Hydatid disease is spread by microscopic eggs present in the faeces of infected dogs. These eggs can be ingested through animal hair, soil or dust and can enter the body if a person does not wash their hands after touching stray dogs or cats.
The infection can also be transmitted from household pets if they are not dewormed regularly. On entering the body, these parasites can form cysts (sacs) in vital organs such as the lungs, liver or brain, causing pressure in the affected area. If the lungs are affected, symptoms such as difficulty in breathing, chest pain and fatigue appear, which often resemble TB and can therefore lead to misdiagnosis.
According to experts, many times general practitioners diagnose TB based only on X-ray reports, without consulting a specialist or getting further investigations done. This increases the chances of misdiagnosis and treatment, especially when the X-ray images resemble other diseases.
Dr Mittal said the patient had a complex and ruptured hydatid cyst in his lungs, which had led to fluid accumulation in the chest. A tube had to be inserted in the chest to drain the fluid. Initially, it was thought to be a sign of TB, but the radiologist overlooked the signs of a hydatid cyst, possibly due to lack of awareness, leading to misdiagnosis.
Delhi and other big cities with a large number of stray dogs are at an increased risk of such infections. Public health experts say that something as simple as feeding or petting stray animals can be dangerous to health.
“People believe that infections are spread only through bites, but many parasites can be spread even without bites. Simple hygiene measures like hand washing are very helpful in preventing these infections,” said Dr Mittal.
The World Health Organisation has classified hydatid disease as a “neglected tropical disease”. The disease is often underdiagnosed in low-resource areas because of low awareness and limited access to advanced testing facilities.
Experts recommend that people who keep pets or come into contact with stray animals report any respiratory problems to their doctor. Often an additional examination can prevent months of incorrect treatment.
Public health advice is that people avoid close contact with stray animals, pay attention to hygiene and seek a second expert opinion if standard treatment does not help.
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