We present the case of a patient with bilateral, pulmonary hydatid cysts who presented for cystectomy and developed life-threatening, haemodynamic instability when turned into the lateral decubitus position. Intraoperative transoesophageal echocardiography allowed for rapid interpretation of the haemodynamic collapse and proved to be valuable in surgical and anaesthetic decision-making. Human immunodeficiency virus co-infection in patients with Echinococcus infection has been implicated in the development of a more severe and disseminated clinical course in hydatid disease.
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