The non-resolving lung cavity: a case of pulmonary cystic echinococcosis

Abstract

The authors report a case of a 20-year-old woman who was diagnosed with pulmonary cystic echinococcosis. She was admitted to hospital with a 1-week history of unresolving cough, coloured sputum with occasional haemoptysis and fever despite oral antibiotics. Radiology revealed a cavitating right lower lobe lung abscess. After 4 weeks of treatment, follow-up radiology showed incomplete resolution. Bronchoscopy revealed a white, avascular cystic lesion in the right lower lobe and serology testing for was positive. Repeat imaging eventually confirmed the cystic lesion with the 'air bubble'sign. A thorough travel history, a high index of clinical suspicion and close follow-up are essential in making a diagnosis of pulmonary cystic echinococcosis.

Diagnostic errors in pulmonary hydatid cyst complicated by spontaneous rupture in the bronchus: clinical case presentation

“…[9][10][11] Usually, the histological examination in these cases highlights the germinal membrane of the cyst, the presence of viable or damaged germinal elements, a mixed inflammatory infiltrate predominantly composed of neutrophils and eosinophils, signs of suppuration and inflammation of the adjacent lung parenchyma. 12 In some cases, the germinal layer detaches from the rest of the cyst and is positioned in the pleural cavity, floating in the effusion. 13 Some authors believe that simple cystotomy and removal of parasitic membranes is the treatment of choice in this complication of the pulmonary hydatid cyst, the meticulous closure of the bronchial openings being mandatory to avoid prolonged air leaks, and padding of the residual cavity is unnecessary.…”