Complicated hydatid cysts of the lung

Introduction Hydatid disease which is caused by the parasite Echinococcus granulosis is one of the most important helminthic diseases. The parasitic infection is endemic in many areas worldwide, including the Mediterranean region. The organs most commonly affected are the liver and the lungs. Purpose The purpose of this study was to exhibit some characteristics of complicated pulmonary hydatidosis such as the clinical, radiological features and therapeutic option. Methods We retrospectively reviewed the medical and radiological records of patients who had hospitalized for complicated pulmonary hydatidosis at the center for Chest Diseases of Hedi Chaker hospital, Sfax, Tunisia, between 1 January 1993 and 31 December 2013. Results 29 cases (mean age = 36,4 years) were evaluated between 1996 and 2013. Rupture of the hydatid cyst occurred into the bronchi in the majority of cases (34,48%) and into the pleur in 13,7%. Extrathoracic involvement was found in 10,3% of the cases. Diagnosis of pulmonary hydatidosis was based on a consistent clinical and radiological presentation. Recourse to CT scan of the chest was helpful for diagnosis in 80% of the patients. The Fibre-optic bronchoscopy allowed the extraction of hydatid cyst membrane in 10% of cases. Surgical treatment was performed in all cases. Medical treatment was associated in 5 cases. Outcome revealed recurrence of pulmonary hydatidosis in 1 patient, and the death of 1 patient with hemorrhagic shock. Conclusion Complicated pulmonary hydatidosis may present some diagnostic difficulties, even in endemic regions. Management may be difficult, costly, and require pulmonary resections.