Background The echinococcosis and tuberculosis of the lungs are both endemic in Algeria. The coexistence of echinococcosis and tuberculosis in the same lobe of the lung is exceptional. Case presentation A 10-year-old girl was admitted with a history of productive cough, fever, and chest pain. Chest examination revealed decreased air entry at left lower lobe. Chest X-ray demonstrated a round left lower lobe with an air fluid interface. Chest CT scan with intravenous contrast showed a lingual hydroaeric formation measuring 5×6 cm with a detached membrane image. A diagnosis of a complicated hydatid disease of the lung was made and the patient was subsequently started on oral albendazole before undergoing exploratory thoracotomy where partial cystectomy and the obliteration of the pericyst cavity. Histopathology was notable for echinococcosis membrane characteristics. After 2 months, the patient re-presented with complaints of cough, hemoptysis, and dyspnea. Radiographic images favored repermeabilization of bronchopleural fistulas. The management was the closing of the bronchial openings. Histological findings include image characteristic of the echinococcosis and tuberculosis. The patient continued on albendazole and an anti-tuberculosis regimen, with concurrent functional physiotherapy sessions. During the following 3-year follow-up, drastic clinical, radiographic, and functional improvement was noted. Conclusion Concurrent tuberculosis and echinococcosis infection should be taken into consideration when patients present with persistent bronchopleural fistula in endemic areas. A multidisciplinary approach of different medical teams facilitates diagnosis and rapid treatment.