Abstract:
Background. Echinococcosis is an endemic zoonotic disease caused by the larval stage of
Echinococcus granulosus. The liver and the lungs are the most frequently affected organs
(56% and 25%). In our country, the disease shows a high prevalence, with an increasing
incidence of multivisceral involvement.
Objective(s). To present a clinical case of pulmonary hydatidosis with an atypical
differential diagnosis and evolution, incidentally revealing multivisceral echinococcosis
through imaging.
Materials and methods. We analyzed the case of a patient with suspected acute pulmonary
infection. Despite antibiotic treatment, the patient showed clinical worsening of the
infectious syndrome and bronchial obstruction, and right-sided pleuritic chest pain. The
patient underwent imaging evaluation by abdominal ultrasound and HRCT of the thorax and
abdomen.
Results. A 20-year-old student was admitted to the Pulmonology Department for
management of pneumonia unresponsive to combined antibacterial therapy. He presented
with a productive cough, worsened when lying down. Laboratory tests showed mild
leukocytosis and absolute eosinophilia, also noted previously and attributed to an intestinal
parasitosis. On liver palpation, a prominent mass was detected in an upright position,
confirmed by ultrasound along with four other hepatic cysts under 6 cm. Thoraco-abdominal
HRCT confirmed five hepatic hydatid cysts and one partially drained pulmonary cyst in the
right S8 segment.The patient was referred to a surgeon.
Conclusion(s). Pulmonary hydatidosis may present atypically, mimicking communityacquired pneumonia. Annual chest radiography, careful evaluation of unexplained
peripheral eosinophilia, sputum analysis, and/or bronchoscopy can support early diagnosis
of pulmonary echinococcosis and an appropriate treatment.
