INOPERABLE DISSEMINATED PULMONARY AND PLEURAL CYSTIC HYDATIDOSIS PRESENTING WITH AN OPAQUE HEMITHORAX IN A 14-YEAR-OLD CHILD

Abstract

Abstract

Introduction: Hydatidosis is a parasitic infection caused by Echinococcus granulosus. People can be infected when they get worm eggs from contaminated puppies during their childhood or from sullied uncooked vegetables in sheep-raising zones of the world. Hydatid disease is generally phenomenal in children, and advanced stages of hydatidosis that are inoperable are uncommon and rarely described in the medical literature. 

Case presentation: We report a case of 14-year-old child diagnosed with advanced inoperable disseminated multiple hydatid cysts who presented with shortness of breath and left shoulder pain. The chest x-ray revealed a complete opacification of the left hemithorax with deviation of the trachea to the right. Thoracic computed tomography scan showed the left hemithorax occupied almost completely with multiple pulmonary, pleural, and chest wall cysts in variable sizes and sites. Abdominal ultrasound showed hepatic cysts. Serology test was positive for hydatid cyst and aspirated fluid showed well-defined scolices. Unfortunately, because of multiorgan disease and multiple cysts, surgery was abandoned at this stage, and medical treatment was started with follow-up schedule. 

Conclusion: In endemic areas, hydatid disease is possible among children, and having a high index of suspicion of hydatid disease is necessary. It should be among the differential diagnoses of any cystic mass lesion. Advanced disseminated disease can be seen in children and can present with generalized left chest opacity. While surgery remains the primary choice of treatment, medical treatment may be preferred in disseminated and multi-organ disease with follow-up evaluations.