A 13th-century cystic echinococcosis from the cemetery of the monastery of Badia Pozzeveri (Lucca, Italy)

Objective: To differentially diagnose a calcified formation recovered from a 13th century AD grave from the Tuscan monastery of Badia Pozzeveri, Lucca, Italy. Materials: A calcified formation from the thoraco-abdominal region of a skeleton buried in the monastery cemetery. Methods: Cone Beam Computed Tomography, Scanning Electron Microscope and Energy Dispersive X-Ray Spectroscopy. Results: A hollow, calcified ovoid formation was identified as typical of a hydatid cyst, permitting the diagnosis of cystic echinococcosis in a 35-45year-old female. Conclusions: The study reveals the circulation of the parasite Echinococcus granulosus in the region of Lucca in late medieval Tuscany. Significance: This finding is the fourth case of cystic echinococcosis from an archaeological context in Italy and provides insight into environmental conditions that appear to have affected members of a community, irrespective of social status. Limitations: Caution and the application of multiple analyses must be exercised in the differential diagnosis to discriminate among calcified formations. Suggestions for further research: Analysis of stable isotopes of the calcified formation, such as 15N and 13C, in order to compare them with isotopic values of the host individual and to further confirm the parasitic origin of the find.