Abstract
Introduction
Hydatid cystic disease is caused by larvae of the Tapeworm Echinococcus. The organs most commonly affected are the liver and the lungs. Pleural involvement is rare, and usually follows the rupture of a pulmonary or hepatic cyst inside the pleural space.
Purpose
The purpose of this study was to exhibit some characteristics of secondary infestation of the pleura as a complication of intrapulmonary echinococcosis.
Materials and methods
We retrospectively reviewed the medical and radiological records of patients who had hospitalized for pulmonary hydatid disease complicated by pleural effusion at the center for Chest Diseases of Hedi Chaker hospital, Sfax, Tunisia, between 1 January 1993 and 31 December 2012.
Results
Five patients were included. There were two females and three males with a mean age of 48. The most common symptoms were cough-sputum (4 cases) and chest pain (3 cases). Chest examination revealed diminished movements over hemithorax with decreased breath sounds in all patients. The most common radiologic finding was the pleural fluid (n=4). The other findings included hydropneumothorax (n=1), air-fluid level mimicking abscess (n=2) and a round cystic opacity (n=3). All patients underwent surgical resection of the pulmonary cysts. In addition, three patients required a pleurectomy. No patient died as a result of echinococcal disease or complications from surgery.
Conclusion
Hydatid cyst rupture in the pleura should be considered in the differential diagnosis of cases with pleural effusion, empyema, pneumothorax and hydropneumothorax occurring in endemic regions. Performing the surgery without delay favorably affects postoperative morbidity and mortality.
- © 2013 ERS