A 9-year-old girl presented with a 6-month history of dyspnea. He had daily contact with dogs in a rural area. The physical examination revealed a decrease in vesicular murmurs in the right hemithorax. Chest computed tomography (Figure 1) revealed a large cyst in the right lung with a slightly thick wall, associated with a smaller and shaped left pulmonary cyst containing gas bubbles that result from its rupture in the respiratory bronchi. An enzyme-linked immunosorbent assay in the patient’s blood showed a
high anti-echinococcus IgG antibody index . Hydatid disease is caused by the echinococcus tapeworm. Man being the intermediate host, is contaminated from contact with an infected dog. This last is the definitive host. After eliminating an associated abdominal localization of the disease, the patient underwent laparotomy consisting of the removal of both cysts, followed by adjuvant anti-helminthic therapy. No recurrence was shown in computed tomography performed three months after treatment .
Figure 1: A 9-year-old girl with bilateral pulmonary echinococcal cysts. A: Frontal view chest X-ray showing the right cyst as a large opacity (big drawn dots circle) associated with lateral-basal lung segment attraction (white arrow) and pleural effusion (black arrow), the left pulmonary cyst appears as a rounded opacity in the inferior lingular segment (small drawn dots circle) containing gas bubbles (arrowheads).B-C: CT image obtained in the coronal (B) and axial (C) planes in the mediastinal window after intravenous administration of iodinated contrast material show the large cyst in the right lung with a slightly thick wall (thick arrows) and homogeneous fluid content, associated with passive atelectasis of the adjacent lung parenchyma (white arrows) and homolateral thin reaction effusion blade (black arrow). The left pulmonary cyst is smaller and shaped containing gas bubbles that result from its rupture in the respiratory bronchi (arrowheads).