The non-resolving lung cavity: a case of pulmonary cystic echinococcosis

BMJ Case Rep. 2017 Jul 31:2017:bcr2017220909. doi: 10.1136/bcr-2017-220909.

Abstract

The authors report a case of a 20-year-old woman who was diagnosed with pulmonary cystic echinococcosis. She was admitted to hospital with a 1-week history of unresolving cough, coloured sputum with occasional haemoptysis and fever despite oral antibiotics. Radiology revealed a cavitating right lower lobe lung abscess. After 4 weeks of treatment, follow-up radiology showed incomplete resolution. Bronchoscopy revealed a white, avascular cystic lesion in the right lower lobe and serology testing for Echinococcus granulosus was positive. Repeat imaging eventually confirmed the cystic lesion with the 'air bubble'sign. A thorough travel history, a high index of clinical suspicion and close follow-up are essential in making a diagnosis of pulmonary cystic echinococcosis.

Keywords: infectious diseases; pneumonia (infectious disease); tropical medicine (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Albendazole / administration & dosage
  • Albendazole / therapeutic use
  • Animals
  • Anthelmintics / therapeutic use
  • Bronchoscopy / methods
  • Diagnosis, Differential
  • Echinococcosis, Pulmonary / diagnostic imaging*
  • Echinococcosis, Pulmonary / drug therapy
  • Echinococcosis, Pulmonary / parasitology*
  • Echinococcosis, Pulmonary / surgery
  • Echinococcus granulosus / isolation & purification*
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Lung / parasitology
  • Lung / pathology
  • Lung Diseases, Parasitic / diagnostic imaging
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Anthelmintics
  • Albendazole