Almousa Maher, Alhadla Ahmad, Aljomaa Mohammad, Abdalrazzak Tamim
College of Medicine Hama University Hama Syria.
Department of Gastroenterology, Aleppo university hospital University of Aleppo Aleppo Syria.
Clin Case Rep. 2023 Jul 30;11(8):e7756. doi: 10.1002/ccr3.7756. eCollection 2023 Aug.
Hydatid disease is a zoonotic disease endemic in developing regions. It is usually caused by infection with the tapeworm due to contaminated food or drinks or by close contact with dogs. The lungs are the second most affected organ (25%) after the liver (>65%). Cyst rupture is the most frequent complication. Enlarging pulmonary cysts are more vulnerable to rupture, with rupturing in the bronchial tree being the most common (20%-40%). Hydropneumothorax is a consequence of complete cyst rupture into the pleural cavity and occurs in rare cases (2%-4%). Superinfection is a common complication of the ruptured cyst, which might lead to empyema. A 26-year-old male presented to our clinic with dyspnea that had progressed recently and made him unable to walk a few meters. He had a history of cough and exertional dyspnea and was examined by three different clinics without performing a chest X-Ray. Physical examination revealed fever and a sick appearance. Chest X-ray revealed complete pneumothorax with an air-fluid level in the left hemithorax. Computerized tomography demonstrated two cysts, and one of them was ruptured, causing hydropneumothorax and empyema. The patient was treated with surgery, and follow-up showed recovery with a fully re-expanded lung. Rupture of pulmonary hydatid cyst is seen in the most of cases, the clinicians must be aware of such presentation and management of the pulmonary hydatid disease.
包虫病是一种在发展中地区流行的人畜共患病。它通常是由于食用或饮用受污染的食物或饮料,或与狗密切接触而感染绦虫所致。肺部是继肝脏(>65%)之后第二受影响最严重的器官(25%)。囊肿破裂是最常见的并发症。不断增大的肺囊肿更容易破裂,其中以破裂进入支气管树最为常见(20%-40%)。液气胸是囊肿完全破裂进入胸腔的结果,发生率很低(2%-4%)。囊肿破裂后的常见并发症是继发感染,这可能导致脓胸。一名26岁男性因近期呼吸困难加重前来我院就诊,已无法行走数米。他有咳嗽和劳力性呼吸困难病史,曾在三家不同诊所就诊,但均未进行胸部X光检查。体格检查发现发热,面容憔悴。胸部X光显示左侧胸腔完全气胸并伴有气液平面。计算机断层扫描显示有两个囊肿,其中一个破裂,导致液气胸和脓胸。该患者接受了手术治疗,随访显示肺部完全复张,康复良好。大多数情况下会出现肺包虫囊肿破裂,临床医生必须了解肺包虫病的此类表现及处理方法。