Empyema and haemothorax due to ruptured pulmonary hydatid cyst- A rare presentation

Hydatidosis is a parasitic infection caused by Echinococcus granulosus (Dog Tape-worm). India is endemic for hydatid disease. The lung is the second most frequently affected organ by hydatid cysts after the liver. Hydatid cysts are mostly seen in the right lower lobe of the lung. We report an unusual presentation of ruptured pulmonary hydatid cyst as empyema and haemothorax in a 24-year-old boy who presented with dyspnoea on exertion with right-sided chest pain. Pleural fluid was suggestive of empyema. The pleural fluid examination revealed plenty of neutrophils and the presence of hooklets of hydatid cyst. Ruptured hydatid cyst is clinically and radiologically confused with many diseases, especially lung cancer. Surgical removal of hydatid cyst is accepted as primary treatment. Thoracotomy was done to excise hydatid cyst. Albendazole was given post-surgery. The patient was discharged on postoperative day 6 with good respiratory capacity. During two months follow up the patient remained asymptomatic.