Document Type : Case Report
Authors
1 Department of Surgery, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Primary pleural hydatid cyst is exceptionally rare, accounting for fewer than 1% of all hydatid disease cases. We reported the case of a 62-year-old woman from a rural area who presented with dyspnea, cough, and weight loss. Initial imaging suggested loculated empyema, and a tube thoracostomy drained purulent material without clinical resolution. Computed tomography (CT) demonstrated pleural thickening and effusion. Video-assisted thoracoscopic surgery (VATS) was performed under the presumptive diagnosis of fibrinopurulent empyema. Intraoperatively, a ruptured primary pleural hydatid cyst was identified and removed. Severe inflammation and fibrosis precluded immediate decortication, necessitating staged management with intrapleural irrigation followed by a subsequent thoracotomy. A superimposed infection with Pseudomonas aeruginosa and Klebsiella pneumoniae complicated the clinical course, requiring repeated interventions. A definitive posterolateral thoracotomy with decortication achieved recovery, and the patient returned to work. This case highlighted that ruptured pleural hydatid cyst can mimic empyema, elude detection by CT and ultrasound, and require clinical vigilance in endemic regions. Although VATS provided essential diagnostic confirmation, open thoracotomy might be required for definitive management.
Highlights
Hamidreza Davari (Google Scholar)
Keywords
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