Presentation of echinococcus infection as lung abscess

A 35-year-old man presented with clinical and radiological features of lung abscess. Despite broad spectrum antibiotics for 5 weeks he remained systemically unwell. Underlying Echinococcus infection was suspected when repeat radiology of his chest showed a water lily sign, and this diagnosis was confirmed at thoracotomy. Hydatid disease may present as lung abscess and cause delay in diagnosis and appropriate therapy.