• View in gallery

    (A) Radiological image showed a cavitary lesion, which is considered a ruptured hydatid cyst. (BD) Noncontrast chest computed tomography scan showed an air-containing cystic lesion with an internal undulating and collapsed germinative membranes representing detached membranes of hydatid cyst.

  • View in gallery

    Axial reformatted unenhanced thorax computed tomography image demonstrates subpleural ground-glass opacities (arrows) in the bilateral lung.

  • View in gallery

    Gross examination showed removed cyst. This figure appears in color at www.ajtmh.org.

  • 1.

    Daimari R, Oyekunle AA, Ocampo C , 2004. Ruptured pulmonary hydatid cyst following the use of albendazole. Am J Trop Med Hyg 98: 15551556.

  • 2.

    Matin S, Talei S, Dalimi A, Dadkhah M, Ghorbani M, Molaei S , 2021. COVID-19 and hydatidosis infections: is there any relationship? Iran J Parasitol 16: 343345.

    • Search Google Scholar
    • Export Citation
  • 3.

    Tekin R, Tekin RC, Avcı A, 2020. Giant hydatid cysts of the lung and liver. Rev Soc Bras Med Trop 16: e20190492.

  • 4.

    Tekin R, Onat S, Tekin RC , 2016. Hydatid cysts in a patient with multiple organ involvement. Rev Soc Bras Med Trop 49: 534.

  • 5.

    Tekin R, Kara AF, Tekin RC, Cimen D , 2011. Cardiac hydatid cyst case recovered with medical treatment. Anadolu Kardiyol Derg 11: 650651.

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Ruptured Pulmonary Hydatid Cyst Complicated by COVID-19

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  • 1 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey;
  • | 2 Department of Thoracic Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey;
  • | 3 Department of Radiology, Mardin State Hospital, Mardin, Turkey

A 51-year-old man with a 1-day history of dyspnea; cough; and production of yellowish, foul-smelling, and salty sputum was admitted to the emergence department. Chest computed tomography (CT) scan revealed a voluminous cavitary lesion in the middle part of the right lung containing irregular, serpiginous intracavitary material compatible with the free-floating membrane of a hydatid cyst (Figure 1). The patient lived in a region endemic for hydatid disease. Eosinophilia in a peripheral blood sample and serum IgG against Echinococcus granulosus was positive at 1/5,120 titer on an immunofluorescence assay test. On the basis of the clinical, laboratory, and radiological findings, ruptured pulmonary hydatid cyst was diagnosed. On the second day of hospitalization, he reported fever, myalgia, and sore throat. A polymerase chain reaction test for SARS-CoV-2 ribonucleic acid from the nasopharyngeal swab confirmed the diagnosis of COVID-19. Chest CT scan was highly suggestive of COVID-19. Axial and coronal reformatted unenhanced thorax CT image demonstrates subpleural ground-glass opacities and vascular dilatation (arrows) in the bilateral lung (Figure 2). The patient underwent enucleation of the hydatid cysts with capitonnage as one-stage posterolateral thoracotomy (Figure 3). Histopathological examination of cysts confirmed the diagnosis of hydatid disease. It is rare for an individual patient to have both ruptured pulmonary hydatid cyst and COVID-19.1,2 COVID-19 during ruptured pulmonary hydatid cyst is potentially serious for the patient. Surgery combined with medical therapy remains the standard form of treatment.3 High clinical suspicion and early imaging diagnosis of this condition can enable clinicians to pursue more aggressive treatment options to reduce fatal outcomes.4,5 Hydatid cyst should be kept in mind in the differential diagnosis of the patients presenting with COVID-19, particularly in those who live in endemic areas.

Figure 1.
Figure 1.

(A) Radiological image showed a cavitary lesion, which is considered a ruptured hydatid cyst. (BD) Noncontrast chest computed tomography scan showed an air-containing cystic lesion with an internal undulating and collapsed germinative membranes representing detached membranes of hydatid cyst.

Citation: The American Journal of Tropical Medicine and Hygiene 107, 1; 10.4269/ajtmh.22-0173

Figure 2.
Figure 2.

Axial reformatted unenhanced thorax computed tomography image demonstrates subpleural ground-glass opacities (arrows) in the bilateral lung.

Citation: The American Journal of Tropical Medicine and Hygiene 107, 1; 10.4269/ajtmh.22-0173

Figure 3.
Figure 3.

Gross examination showed removed cyst. This figure appears in color at www.ajtmh.org.

Citation: The American Journal of Tropical Medicine and Hygiene 107, 1; 10.4269/ajtmh.22-0173

REFERENCES

  • 1.

    Daimari R, Oyekunle AA, Ocampo C , 2004. Ruptured pulmonary hydatid cyst following the use of albendazole. Am J Trop Med Hyg 98: 15551556.

    • Search Google Scholar
    • Export Citation
  • 2.

    Matin S, Talei S, Dalimi A, Dadkhah M, Ghorbani M, Molaei S , 2021. COVID-19 and hydatidosis infections: is there any relationship? Iran J Parasitol 16: 343345.

  • 3.

    Tekin R, Tekin RC, Avcı A, 2020. Giant hydatid cysts of the lung and liver. Rev Soc Bras Med Trop 16: e20190492.

  • 4.

    Tekin R, Onat S, Tekin RC , 2016. Hydatid cysts in a patient with multiple organ involvement. Rev Soc Bras Med Trop 49: 534.

  • 5.

    Tekin R, Kara AF, Tekin RC, Cimen D , 2011. Cardiac hydatid cyst case recovered with medical treatment. Anadolu Kardiyol Derg 11: 650651.

Author Notes

Address correspondence to Recep Tekin, Department of Infectious Disease, Faculty of Medicine, Dicle University, Yenişehir 21280 Diyarbakır, Turkey. E-mail: receptekin@yahoo.com

Authors’ addresses: Recep Tekin, Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey, E-mail: receptekin@yahoo.com. Sedar Onat, Department of Thoracic Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. Rojbin Ceylan Tekin, Department of Radiology, Mardin State Hospital, Mardin, Turkey.

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