Pulmonary Hydatid Cyst in Children and Adults: Diagnosis and Management

Abstract

Hydatid cyst disease induced by Echinococcus granulosus is a parasitic disease known since ancient times. Today, it continues to be seen in many countries and creates serious problems. The lung is the second most frequently affected organ by hydatid cysts after the liver. Lung involvement is more prevalent in children than adults, and the growth of the cyst is faster in children. Hydatid cysts are mostly seen in the right lower lobe of the lung. Common symptoms are chest pain, cough, and shortness of breath, with the most diagnostic symptom being the expectoration of cyst fluid or membranes. In endemic areas, the diagnosis of hydatid cysts can usually be made easily by clinical findings, serology tests, and radiological findings. When the hydatid cyst ruptures and becomes complicated, it is clinically and radiologically confused with many diseases, especially lung cancer. Surgery is accepted as primary treatment of lung hydatid cysts all over the world. The surgical approach is related to several factors such as the size of the cyst, whether it is intact or complicated, unilateral or bilateral, solitary or multiple, and the presence of destruction of the lung parenchyma. Although it is stated by some surgeons that capitonnage is not required, the most frequently applied surgical technique is cystotomy and capitonnage. Pulmonary resection should be avoided as much as possible, particularly in children. Albendazole or mebendazole treatment in pulmonary hydatid cyst is generally used after surgery and to prevent recurrences.

Thoracotomy in Children: Review from a Low-Income Country

“…This is due to the high elasticity and compressibility of the lungs in children. [24][25][26] In one retrospective review of pediatric hydatid cysts from our institution, the lung was found to be the most common site of involvement in 76.5% of the children. 27 Pulmonary hydatid cyst was also the most common indication for thoracotomy in a study from Turkey in which it accounted for 35% of the procedures.…”

The co-infection of pulmonary hydatid cyst, lophomoniasis and tuberculosis in a patient with resistant respiratory symptoms; a case report study

“…In addition, due to the positive E. granulosus -specific IgM and IgG, active tuberculosis, our patients were more likely to have co-infection M. tuberculosis and E. granulosus with lophomonas. The study by Kalani M., et al 2022, mentioned that the prevalence of lophomonas infection was relatively high in patients with suspected tuberculosis due to similar clinical manifestations of this co-infection ( 1 , 2 – 4 , 11 , 12 ).…”

“…Treating pulmonary E. granulosus infection could be pharmacotherapy or surgical intervention, and surgical intervention is the treatment choice. A benzimidazole group (albendazole and mebendazole) could be prescribed for medical treatment [ 4 , 9 – 11 ].…”

A life-threatening encounter: an uncommon case of ruptured hydatid cyst presenting as anaphylactic shock and respiratory distress in a 12-year-old boy

“…The choice of surgical approach in HD is influenced by several factors, including cyst size, whether it is intact or complicated, its unilateral or bilateral nature, whether it is solitary or multiple, and the extent of lung parenchyma destruction. Among the various surgical techniques, cystotomy and capitonnage are the most commonly applied methods in clinical practice 23 . In cases where an intact cyst ruptures, prompt surgical intervention becomes imperative to minimize the risk of infection, as the cyst cavity is now in communication with the airway, and the remaining membrane remnants can serve as a nidus for infection.…”