Ruptured Pulmonary Hydatid Cyst Complicated by Tension Pneumothorax: A Rare Case Report

Cystic echinococcosis (CE), or hydatid disease, is a zoonotic parasitic infection caused by Echinococcus granulosus. Although primarily hepatic, pulmonary involvement accounts for 10% to 30% of cases. Rupture of pulmonary hydatid cysts can lead to life-threatening complications such as pneumothorax and anaphylaxis.

We report the case of a 20-year-old female from Syria who presented with sudden-onset dyspnea, pleuritic chest pain, palpitations, and dry cough. Imaging revealed a massive right-sided pneumothorax with a ruptured hydatid cyst in the right middle lobe, evidenced by the presence of a Water Lily sign. Emergency decompression and chest tube insertion were performed, followed by definitive surgical intervention with cyst excision and capitonnage. The postoperative course was uneventful, and the patient achieved full radiological and clinical recovery.

Pulmonary hydatid cysts are often asymptomatic but may become acutely symptomatic upon rupture. Diagnosis relies on imaging, particularly CT, and can be supported by serology. While medical therapy is reserved for select cases, surgery remains the mainstay of treatment, especially in complicated or large cysts. Intraoperative precautions are crucial to avoid recurrence.

This case highlights the importance of early recognition and multidisciplinary management of ruptured pulmonary hydatid cysts. Prompt surgical intervention following stabilization can lead to favorable outcomes even in cases complicated by tension pneumothorax.