Management of ruptured pulmonary hydatid cyst presenting with massive haemoptysis in a 4-year-old child: a case report

Abstract Hydatid disease (HD) is a zoonotic parasitic infection caused by Echinococcus granulosus and remains endemic in many regions. In children, pulmonary involvement is more common than hepatic disease and is often asymptomatic or mildly symptomatic. Massive hemoptysis as an initial presentation in early childhood is extremely rare. We report a case of a previously healthy 4-year-old boy who presented with a 3-day history of productive cough and massive hemoptysis without fever or systemic symptoms. Chest radiography showed right-sided consolidation, and contrast-enhanced computed tomography revealed a large cavitary lesion in the right middle lobe suggestive of a ruptured hydatid cyst. The patient underwent successful video-assisted thoracoscopic surgery-assisted mini-thoracotomy excision with chest tube placement, followed by albendazole therapy. Recovery was uneventful with excellent outcome. This case highlights the need to consider pulmonary HD in the differential diagnosis of hemoptysis in children living in endemic areas and supports minimally invasive surgical management when feasible.