# Spontaneous rupture of the pulmonary hydatid cyst in a young male leading to a complicated pneumothorax: A case report and review of literature

## TL;DR

A young man experienced a lung hydatid cyst rupture causing pneumothorax, requiring surgery and emphasizing the importance of considering this rare condition in diagnostic evaluations.

## Contribution

This case report highlights the rare complication of spontaneous rupture of a pulmonary hydatid cyst leading to pneumothorax and empyema.

## Key findings

- Spontaneous rupture of a pulmonary hydatid cyst can lead to pneumothorax and empyema requiring surgical intervention.
- CT scan is the preferred imaging modality for diagnosing complicated hydatid cysts.
- Surgical excision is recommended for complicated or ruptured hydatid cysts.

## Abstract

Hydatid disease, caused by the Echinococcus tapeworm, can form cysts in various parts of the body, mostly in the liver and lungs. These cysts may remain asymptomatic in the lungs or, upon rupture, can lead to pneumothorax and empyema.

We present a case of a 22-year-old male presented with sudden onset of chest pain and dyspnea. After being referred to our hospital and based on physical examination and CT scan findings, he was diagnosed with spontaneous rupture of a pulmonary hydatid cyst. During thoracotomy, massive amounts of empyema and necrotic tissues were discovered in the pleural cavity which were surgically removed. The patient had unremarkable recovery; as his respiratory symptoms were totally resolved, he was discharged within a week with a chest tube inserted.

Despite being rare, hydatid disease should be considered as a differential diagnosis for pneumothorax, pleural effusion and empyema in the pleural cavity, particularly in endemic regions. Non-complicated cysts, could be discovered by chest X ray, However, for complicated cysts, CT scan is the choice for diagnosis.

In endemic regions, hydatid cysts should be considered an important differential diagnosis for nonspecific respiratory symptoms, and a surgical approach should be considered for excising the cyst remnants.

•In the endemic regions of hydatid disease, unspecific pulmonary symptoms should be assessed more carefully, with having hydatid cyst in mind.•Lungs are the second most common site of cyst formation, following the liver and clinical symptoms vary by the size or condition of the cyst.•Hydatid cysts may remain asymptomatic in the lungs or upon rupture, result in pneumothorax and empyema.•In the case of non-complicated cysts, chest X ray is proved to be beneficial; otherwise, for complicated cysts, CT scan is the choice of imaging.•Surgery is the choice of treatment, particularly in patients with complicated or ruptured cysts.

In the endemic regions of hydatid disease, unspecific pulmonary symptoms should be assessed more carefully, with having hydatid cyst in mind.

Lungs are the second most common site of cyst formation, following the liver and clinical symptoms vary by the size or condition of the cyst.

Hydatid cysts may remain asymptomatic in the lungs or upon rupture, result in pneumothorax and empyema.

In the case of non-complicated cysts, chest X ray is proved to be beneficial; otherwise, for complicated cysts, CT scan is the choice of imaging.

Surgery is the choice of treatment, particularly in patients with complicated or ruptured cysts.