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Background <p>This report describes the clinical presentation and management of aruptured giant thoracic hydatid cyst in a young adult, highlighting the diagnostic and therapeuticchallenges associated with pulmonary echinococcosis, particularly in endemic regions. The caseemphasizes the importance of early recognition to prevent severe complications.</p> Methods <p>A 22-year-old college student from Iran presented with progressive dyspnea, chest pain, fever, cough,and hemoptysis. Imaging studies, including chest radiography and computed tomography, wereperformed, revealing a giant cystic lesion in the left hemithorax with the pathognomonic “waterlily” sign. Surgical intervention via posterolateral thoracotomy was undertaken, involvingcomplete aspiration of the cyst, cavity cleansing, and chest tube placement.</p> Results <p>Intraoperative findings confirmed a giant ruptured hydatid cyst. The cyst was successfully excised, and the patient received postoperative albendazole therapy to prevent recurrence. Histopathological examination confirmed the diagnosis of Echinococcus granulosus infection. The patient’s symptoms resolved following surgery, with no immediate postoperative complications.</p> Conclusion <p>Ruptured pulmonary hydatid cysts can present with acute respiratory symptoms and characteristic imaging signs such as the “water lily” sign. Surgical removal remains the cornerstone of treatment, complemented by antiparasitic medication. In endemic areas, heightened clinical suspicion and prompt intervention are essential to reduce morbidityand prevent life-threatening hypersensitivity reactions.</p> Graphical Abstract <p>Diagnostic Pathway for Pleural Effusion in Pulmonary Hydatid Disease. This graphical abstract outlines the diagnostic approach to a patient from an endemic region presenting with respiratory symptoms. It emphasizes the critical diagnostic challenge: pleural fluid analysis can reveal either a classic eosinophilic exudate or a misleading transudate. The pathway demonstrates that irrespective of this biochemical finding, a definitive diagnosis relies on a systematic combination of imaging, serology, and crucially, cytological examination for hooklets, leading to appropriate management with surgery and albendazole.</p> <p></p>

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Ruptured Pulmonary Hydatid Cyst with Massive Eosinophilic Pleural Effusion: A Case Report and Literature Review

  • 期刊论文

  • 发表日期：

    2026年2月11日

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  • Mehdieh Sadat Mehdizadeh,
  • Niloofar Khoshnam Rad,
  • Milad Nasrollahzadeh,
  • Hossein Kazemizadeh

摘要

Background

This report describes the clinical presentation and management of aruptured giant thoracic hydatid cyst in a young adult, highlighting the diagnostic and therapeuticchallenges associated with pulmonary echinococcosis, particularly in endemic regions. The caseemphasizes the importance of early recognition to prevent severe complications.

Methods

A 22-year-old college student from Iran presented with progressive dyspnea, chest pain, fever, cough,and hemoptysis. Imaging studies, including chest radiography and computed tomography, wereperformed, revealing a giant cystic lesion in the left hemithorax with the pathognomonic “waterlily” sign. Surgical intervention via posterolateral thoracotomy was undertaken, involvingcomplete aspiration of the cyst, cavity cleansing, and chest tube placement.

Results

Intraoperative findings confirmed a giant ruptured hydatid cyst. The cyst was successfully excised, and the patient received postoperative albendazole therapy to prevent recurrence. Histopathological examination confirmed the diagnosis of Echinococcus granulosus infection. The patient’s symptoms resolved following surgery, with no immediate postoperative complications.

Conclusion

Ruptured pulmonary hydatid cysts can present with acute respiratory symptoms and characteristic imaging signs such as the “water lily” sign. Surgical removal remains the cornerstone of treatment, complemented by antiparasitic medication. In endemic areas, heightened clinical suspicion and prompt intervention are essential to reduce morbidityand prevent life-threatening hypersensitivity reactions.

Graphical Abstract

Diagnostic Pathway for Pleural Effusion in Pulmonary Hydatid Disease. This graphical abstract outlines the diagnostic approach to a patient from an endemic region presenting with respiratory symptoms. It emphasizes the critical diagnostic challenge: pleural fluid analysis can reveal either a classic eosinophilic exudate or a misleading transudate. The pathway demonstrates that irrespective of this biochemical finding, a definitive diagnosis relies on a systematic combination of imaging, serology, and crucially, cytological examination for hooklets, leading to appropriate management with surgery and albendazole.