Isolated Pulmonary Hydatid Cysts: Two Opposite Presentations but One Similar Positive Outcome

Abstract Cystic echinococcosis is a helminthic zoonotic disease caused by Echinococcus granulosus that affects the liver more as compared to lungs. Isolated pulmonary hydatid cysts are less common and can present as different respiratory manifestations. Here we have reported two different cases of isolated pulmonary hydatid cysts which were presented differently but managed successfully. In the first case, a 27-year-old young housewife presented with cough, fever, and loss of weight for 1 month without any respiratory distress. Her chest X-ray and contrast enhanced computed tomography (CECT) thorax revealed a large well-defined cystic fluid density lesion with enhancing thick wall in the left upper lobe. En bloc cyst excision was done by cardiothoracic surgeon. Intraoperatively, hydatidosis was found as a pale, shining cystic, single fluid-filled cavity and which was confirmed by histopathology. In another case, a 24-year-old male presented in the emergency department with the acute onset of breathlessness with respiratory distress for few days. Chest X-ray and CECT chest revealed pneumothorax with well-defined cystic lesion with internal air fluid level in right lower lobe and internal laminated floating membrane within fluid suggestive of ruptured hydatid cyst. The patient was stabilized initially and underwent cyst excision by cardio-thoracic surgeon after some days. In this case, intraoperatively ruptured hydatid cyst was found and abscess cavity was debrided. Microbiology and histopathology of debrided cyst confirmed the diagnosis. An isolated pulmonary hydatid cyst can present either as a simple nonruptured space-occupying pulmonary cyst or as a complicated ruptured pulmonary cyst making patient unstable. Timely surgical intervention can have an excellent outcome.