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| CASE REPORT |
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| Year : 2012 | Volume
: 2
| Issue : 1 | Page : 69-70 |
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Hydatid disease of the lung presenting with hemoptysis and simulating a lung abscess
Sunita Toleti1, MV Subbarao2, Pragathi Dwarabu2
1 NRI Medical College, Chinakakani, India
2 TB and Chest Department, NRI General Hospital, Chinakakani, India
| Date of Acceptance | 16-Jan-2012 |
| Date of Web Publication | 16-Jun-2012 |
Correspondence Address:
Sunita Toleti
NRI Medical College, Chinakakani, Mangalagiri Mandal, Guntur District, Andhra Pradesh
India
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DOI: 10.4103/2229-5070.97248 PMID: 23508291 
 Abstract | | |
Hydatidosis is one of the most important zoonotic diseases in the world. In this report, we describe a 25-year-old patient from Guntur district of Andhra Pradesh who presented with cough, chest pain, dyspnoea, and hemoptysis due to hydatid disease of the lung. Although it is one of the less common causes of hemoptysis, hydatid disease of the lung requires greater attention in countries such as India, where hydatid cyst disease is common. Keywords: Hemoptysis, hydatid cyst, lung
How to cite this article:
Toleti S, Subbarao M V, Dwarabu P. Hydatid disease of the lung presenting with hemoptysis and simulating a lung abscess. Trop Parasitol 2012;2:69-70 |
| Introduction | |  |
Hydatid disease is a parasitic infestation caused by Echinococcus granulosus characterized by cystic lesions in liver and other parts of the body. [1] Humans contract the disease from water or food or by direct contact with dogs. If the hexacanth embryos overcome the hepatic obstacle, they lodge in the lungs, where they transform into hydatids. The embryos can reach the lung via the lymphatics, bypassing the liver, and disease can be contracted through the bronchi also. [2] This paper emphasizes the fact that hydatid disease should be suspected in cystic lesions affecting any organ in the body, especially in endemic areas.
| Case Report | | |
A 25-year-old male from Guntur District of Andhra Pradesh presented to the Tuberculosis and Chest department of NRI General Hospital, Chinakakani with complaints of productive cough, chest pain, hemoptysis, and dyspnoea for the last four months. There was history of occasional fever but no weight loss. Physical examination revealed bilateral rhonchi on auscultation.
Blood picture showed leucocytosis with eosinophilic preponderance. Routine examination of blood and urine disclosed normal findings and the sputum was repeatedly negative for acid-fast bacilli. Computed tomography (CT) scan impression was a 6×6.9×5.9 cm hypodense lesion in the posterior segment of the lower lobe of the right lung with minimal adjacent loculated effusion-probably lung abscess [Figure 1]. Ultrasound guided aspiration was done and fluid analysis revealed viable scoleces [Figure 2]. | Figure 1: CT scan impression showing 6×6.9×5.9 cm hypodense lesion in the posterior segment of the lower lobe of the right lung
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 | Figure 2: Microscopy of aspirated fluid showing scolices of Echinococcus granulosus
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Treatment and surgery
A large unilocular hydatid cyst was removed from the right lung through a right thoracotomy. Oral albendazole 400 mg b.i.d. was given for 5 days preoperatively and 4 weeks post operatively.
| Discussion | | |
Haemoptysis in adults is most often caused by tuberculosis, bronchiectasis and trauma or bronchogenic carcinoma. Parasitic etiology is very rare. The mechanism of hemoptysis may be due to pressure erosion of a bronchus or an obstructive effect with bronchial infection. Hydatid cysts of the lungs are commonly solitary, well-circumscribed and unruptured. [3] and usually occur at lung bases. [4] Sometimes the appearance is so atypical as to present a challenging diagnostic problem. [5] Our case highlights the rarity of the nature of involvement where a radiologically suspected case of lung abscess turned out to be a hydatid cyst of the lung.
The operative findings showed 5×6 cm hydatid cyst with surrounding thick wall in middle lobe of right lung bronchial opening in the cavity.
| Conclusion | | |
This case report suggests that when a patient presents with hemoptysis, zoonotic infections, especially hydatid disease of the lung, should always be considered alongside other common causes of hemoptysis. Although it is one of the less common causes of hemoptysis, hydatid disease of the lung requires greater attention in countries, such as India, in which hydatid cyst disease is common.
| References | | |
| 1. | Safioleas M, Misiakos EP, Dosios T, Manti C, Lambrou P, Skalkeas G. Surgical treatment for lung hydatid disease. World J Surg 1999;23:1181-5. 
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| 2. | Burgos R, Varela A, Castedo E, Roda J, Montero CG, Serrano S, et al. Pulmonary hydatidosis: Surgical treatment and follow-up of 240 cases. Eur J Cardiothorac Surg 1999;16:628-34; discussion 634-5.
[PUBMED] [FULLTEXT] |
| 3. | Anantharaman M. Pulmonary hydatidosis in India: An overview. Lung India 1983;1:123-7.
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| 4. | Kulpati DD, Hagroo AA, Talukdar CK, Ray D. Hydatid disease of lung. Indian J Chest Dis 1974;16:406-10.
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| 5. | Balikian JP, Mudarris FF. Hydatid disease of the lungs: A roentgenologic study of 50 cases. Am J Roentgenol Radium Ther Nucl Med 1974;122:692-707.
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[Figure 1], [Figure 2]
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