ABSTRACT
OBJECTIVE: To improve the clinical recognition of pulmonary hydatid cyst rupture. METHODS: Retrospective analysis of the misdiagnosis of 38 cases of hydatid cyst rupture. RESULTS: The diagnosis of hydatid cyst rupture was confirmed by surgery and pathological study. The disease was misdiagnosed as pneumonia in 11 cases, lung abscess in 4, tuberculosis in 13, tumor in 6, pleuritis in 2, and pneumothorax in 2 cases. The clinical manifestations included sudden onset cough, watery sputum, and fever. Casoni test was positive in all the cases. Chest X-ray showed right lung cysts in 26 cases, left lung cysts in 12 cases. Large irregular opacities were found in 18 cases, round lesions in 8, new moon sign on top of the cysts in 4, floating lotus sign in 4, pneumothorax in 2, and pleural effusion in 2 cases. After combination therapy with anti-infection, support and surgery by which hydatid were excised in 28 cases and lobectomy in 9 cases, all the 38 cases were cured. CONCLUSION: Hydatid cyst rupture can be misdiagnosed as other lung diseases, most commonly pneumonia and tuberculosis.