Echinococcal disease and mycobacterial infection.

The clinical and radiological features of five patients with echinococcal disease in whom mycobacterial infection was also present are described. Three had clinically significant disease due to Mycobacterium tuberculosis (two patients) and M. fortuitum-chelonae (one patient), whilst in two others secondary infection with M. gordonae had occurred. In all cases the mycobacterium infection was found within or close to the anatomical confines of the echinococcal disease, as determined clinically, radiologically or histologically, which suggested a saprophytic-supportive role of the hydatid cyst for the mycobacterium to survive. Mycobacterial disease should be borne in mind in patients with echinococcal disease who remain unwell despite apparently effective treatment for the hydatid cyst.