A Clinical Encounter With Intrathoracic Extrapulmonary Hydatid Disease

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.