Echinococcus granulosus causes hydatid cysts, a significant zoonotic and pulmonary parasitic disease that can mimic various pathologies and is often harder to manage than the disease itself. A hydatid cyst is considered a significant health problem in India, Iran, China, and Mediterranean countries, which lack satisfactory environmental health, preventive medicine, and veterinarian services. Echinococcosis continues to be a major community health burden in several countries, and in some terrains, it constitutes an emerging and re-emerging disease. Cystic echinococcosis is the most common human disease of this genus, and it accounts for a significant number of cases worldwide. Herein, a case involving an 11-year-old presenting with fever, dry cough, and right hypochondrial pain is presented, where imaging revealed a hydatid cyst in the lung. Surgical removal of the cyst was achieved through right posterolateral thoracotomy under one-lung ventilation and anesthesia using intubation with a double-lumen endotracheal tube (DLET or DLT), highlighting surgery as the primary treatment despite the lack of consensus on surgical methods. This case underscores the effectiveness of individualized, parenchyma-preserving surgery for even large, uncomplicated cysts, indicating a positive prognosis.

Pulmonary echinococcosis is a parasitic infection that accounts for 20% of the infected cases with echinococcosis. Patients may present after a cyst rupture associated with a variety of complications, including acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) is known as supportive therapy for patients with respiratory and cardiac failure, including ARDS associated with multiple causes. Parasitic infection associated with ARDS due to cyst rupture managed with ECMO as bridging to definitive surgical intervention is documented in two previous case reports only. Here, we are presenting a 21-year-old female with a pulmonary hydatid cyst complicated by ARDS and managed with ECMO.

BACKGROUND: Co-infection with other microorganisms such as parasites in patients with COVID-19 can affect the clinical outcome and require prompt diagnosis and appropriate therapy.
METHODS: We present a case of an adult male with chest pain, dyspnea, cough, diplopia, and anorexia who was confirmed to have acute COVID-19 pneumonia. 2 weeks prior to admission, a hydatid lung cyst was identified on examination, but the patient refused surgery. Thoracoabdominal computed tomography (CT) revealed a rupture of the lung hydatid cyst and co-infection with COVID-19. The patient has prescribed a treatment protocol for COVID-19 and albendazole. Despite measures taken to manage severe inflammation and decreasing blood oxygen levels, the patient required admission to the intensive care unit (ICU) and intubation. After approximately 3 weeks of hospitalization, the patient was successfully extubated and discharged uneventfully from the hospital. Oral albendazole was prescribed for follow-up treatment.
CONCLUSIONS: Our case highlights the importance of considering hydatid cysts in the differential diagnosis of patients with COVID-19, especially those living in endemic areas.

Intrathoracic extrapulmonary hydatid disease is an uncommon variant of hydatidosis. In this report, we describe a rare case of a 53-year-old female who presented with a left-side massive hydropneumothorax, initially treated as tubercular empyema and later came out to be intrathoracic extrapulmonary hydatid disease, with no signs of primary lesion in the lung. This case was managed with an intercostal drain insertion followed by a thoracoscopic-guided excision of the cyst, which on histopathological examination confirmed the diagnosis. Also, the Echinococcus antibody IgG test confirmed the same. The patient was then initiated on oral albendazole which showed a drastic reduction in the intrapleural cysts, but the patient later developed non-resolving pyopneumothorax with a bronchopleural fistula. The patient is being managed conservatively at present with oral albendazole and chest drain and is later advised to undergo decortication surgery of the lung.

Echinococcosis, commonly known as hydatid disease, is a zoonotic infection caused by dog tapeworm Echinococcus granulosus. Hydatid disease of the head and neck region is scarcely reported even in endemic areas. We herein report a case with with neck swelling and respiratory symptoms subsequently diagnosed to have disseminated echinococcosis of the neck and left lung.

UNASSIGNED: Although video-assisted thoracoscopic surgery (VATS) plays an increasingly significant part in treating thoracic disease, the role of thoracotomy is not replaced in cystic echinococcosis. The aim of this study was to demonstrate the application of VATS and traditional thoracotomy in the treatment of pulmonary hydatid disease in Shigatse of the Tibet Plateau and to compare the clinical safety and efficacy of these two surgical approaches.
UNASSIGNED: A total of 53 patients with pulmonary hydatid who received thoracoscopic cystectomy with needle aspiration from January 2015 to December 2020 were enrolled in the study, and 126 patients who received thoracotomy during the same period were matched as the control group. The clinical characteristics, operative time, incidence of perioperative complications, length of stay, and hospitalization cost of the VATS and thoracotomy groups were analyzed to compare the safety and efficacy. Patients were followed up through telephone and outpatient service. In order to balance potential confounding baseline factors, propensity-score matching (PSM) was applied to establish a 1:1 VATS to thoracotomy group ratio.
UNASSIGNED: There were statistically significant differences between the VATS group and the thoracotomy group in operative time, blood loss, drainage volume, and postoperative hospital stay (P<0.05), with the VATS group being superior to the thoracotomy group. There were no significant differences in postoperative complications, adverse imaging outcomes, or recurrence rates between the 2 groups. In terms of complications, there was no significant difference in the incidence of postoperative air leakage, atelectasis, or other common complications between the 2 groups, while the frequency of postoperative fever and incision infection in the thoracotomy group was significantly higher than that in the VATS group (P<0.05). Moreover, the postoperative recurrence rate between the 2 groups showed no significant difference after a 3-year follow-up.
UNASSIGNED: Compared to traditional thoracotomy, VATS had acceptable efficacy and safety and it could further accelerate postoperative recovery and reduce the cost in the treatment of pulmonary hydatid disease in the Tibetan Plateau. Thus, VATS should be promoted more widely to other Tibetan regions.

UNASSIGNED: Hydatid disease is a zoonotic disease caused by Echinococcus. Surgery remains the gold standard approach of treatment.
UNASSIGNED: This study reports on 10 years of experience on surgical management of 78 cases of pulmonary hydatid disease and compares the rates of post-surgical complications between three approaches.
UNASSIGNED: Three different surgical approaches - the Ugon method, cystectomy and lobectomy - were performed for pulmonary hydatid disease treatment during a 1-year follow-up program. The relationships between patient\'s age, sex, cyst location and surgical approach and occurrence of post-surgical complications were first assessed. Then post-surgical complications between these three methods were compared.
UNASSIGNED: From 78 patients, 51.5% were female and 48.5% were male (whose average age was 36.1). Hydatid cysts were found in the right (43.58%) and left (37.17%) lung while 19.23% of patients had bilateral cysts. Patient\'s age, sex and cyst location did not have any significant effect on the occurrence of complications. Post-surgical complications were only dependent on the surgical approach. 23% of the patients had post-surgical complications (including air leak, fistula, empyema, seroma and wound infection) and air leak was the most frequent one.
UNASSIGNED: Since complications were only dependent on the surgical method, the rate of post-surgical complications were compared between the three approaches. Cystectomy and lobectomy had similar rates of complications, which were lower than that of the Ugon method. It can be concluded that cystectomy is the method of choice for management of pulmonary hydatid disease, with the lowest rate of complications.

OBJECTIVE: The aim of this study was to investigate the role of 18F-fluorodeoxyglucose positron emission tomography/computerized tomography (FDG-PET/CT) in the diagnosis and treatment of pulmonary hydatid disease and also compare the morphological characteristics of the lesions with SUVmax values and identify complicated disease.
METHODS: Thirty-six patients with a diagnosis of pulmonary hydatid disease who underwent 18F-FDG PET/CT imaging were included in this retrospective study. The size of the lesions, morphological characteristics, accompanying parenchymal and pleural findings, SUVmax and HUmean values and FDG uptake in mediastinal lymph nodes were noted. The relationship between morphologic properties, SUVmax of the lesions and lymphatic FDG uptake was analysed.
RESULTS: A total of 99 lesions of 36 patients were classified as solid (7.1%), cystic (53.5%), semisolid (20.2%) and cavitary (19.2%). Thirty-two of the lesions were encapsulated, 38 of the lesions had border irregularity. Accompanying consolidation was present in 10 cases, bronchial obstruction in 9, pleural thickening in 28 and effusion in 3. There was positive correlation between lesions HUmean and SUVmax values (r = 0.285). SUVmax values were significantly higher in lesions with irregular borders, solid or semisolid type and presence of consolidation, bronchial obstruction and pleural thickening. Also more lymphatic FDG uptake was detected in this group.
CONCLUSIONS: Higher SUVmax values may be a useful parameter in the diagnosis of complicated pulmonary hydatid disease. FDG-PET may provide guidance for determining the priority of lesion for surgery in cases with multiple lesions and may be helpful to evaluate the response to medical treatment.

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BACKGROUND: Hydatid disease is a severe and widespread human cestode infection, and in children, the lung is the most commonly infected organ. In current practice, the standard surgical procedure for the removal of pulmonary hydatid cysts is thoracotomy; therefore, we evaluated the efficacy and safety of video-assisted thoracoscopic surgery (VATS) to treat pediatric pulmonary hydatid disease. To our knowledge, this is the first and large sample comparative study of VATS and thoracotomy for pediatric pulmonary hydatid disease.
METHODS: In this study, we retrospectively reviewed 44 (61.1 %) pediatric patients who underwent VATS, and 28 (38.9 %) pediatric patients who underwent conventional thoracotomy from January 2005 to June 2012. Perioperative data, including basic characteristics of patients, the length of hospital stay, intraoperative blood loss, thoracic intubation indwelling time, and complications were compared between VATS and thoracotomy in 72 children with pulmonary hydatid disease.
RESULTS: VATS was found to be a safe technique for the treatment of pediatric pulmonary hydatid disease, with zero intraoperative deaths. In the VATS and thoracotomy groups, the hospital stay durations were 10.50 ± 1.20 days and 17.30 ± 2.75 days, respectively, and occurrence rates of complications were 9.1 % (4/44) and 17.9 % (5/28), respectively. The hospital stays were shorter and the hospitalization costs was reduced for the patients who underwent VATS compared with conventional thoracotomy (P = 0.001). Although no statistically significant difference in the recurrence rates (P = 0.958) and complication incidence (P = 0.273) between the two surgical groups was observed, less intraoperative bleeding, shorter thoracic intubation indwelling time and reduced postoperative pain were observed in the patients who underwent VATS (P = 0.001).
CONCLUSIONS: Our study demonstrates the feasibility and safety of VATS for pediatric pulmonary hydatid disease treatment, providing a practice-changing concept for the treatment of this disease in the community. VATS can be a promising therapeutic tool, by overcoming many of the drawbacks of thoracotomy, and can be used as an alternative to thoracotomy for selected pediatric patients.