Introduction: Complicated pulmonary hydatid presents with diagnostic dilemma due to variable radiological appearance. Objective: To study bronchoscopic findings and surgical pathology of pulmonary hydatid. Methods: From January 2002 to December 2008, 14 patients, aged between 18 and 55 years with a mean age of 36 years, were evaluated for pulmonary hydatidosis. Clinical histories, radiological findings and investigations of the patients were reviewed retrospectively in tertiary referral hospital. Results: All 14 patients were symptomatic, cough, hemoptysis and chest pain being the most common symptoms. 7 cases had right lung involvement while 6 cases had lower lobe predilection and one case was of pleural hydatid. Only one patient had associated liver and spleen hydatid cysts. Nine patients presented with complicated hydatid cysts. On bronchoscopy white glistening membrane was seen in 9 patients while cuticular particles, degenerated scoleces, and hooklets were not seen in bronchial washing specimen. 12 patients underwent surgical resection. No complications were noted post operatively. Surgical specimen showed nine ruptured hydatid, two cases each with evidence of fungal (aspergillus) colonization, bacterial infection and coexistent tuberculoses granulomatous feature. Conclusions:. Fibreoptic bronchoscopic evaluation is an important tool for the diagnosis of complicated pulmonary hydatidosis. Surgery is indicated in all symptomatic and ruptured cysts and it is associated with minimal post operative complication. Histopathology of surgical specimen should be reviewed for associated secondary infection, fungal colonization and especially tuberculosis in region with high prevalence.
Full conference title:
20th European Respiratory Society conference
- ERS 20th (2010)