Pulmonary Hydatid Cyst Rupture Associated With Albendazole Commencement: Case Report and Literature Review.

We report a 54-year-old immunocompetent female of Pakistani origin who presented with a 3 month history of abdominal fullness associated with hepatic and pulmonary cysts suggesting hydatid disease but negative Echinococcus granulosus serology. The hepatic cyst was resected, confirming hydatid disease, and perioperative albendazole was continued to treat the smaller pulmonary cyst. Three weeks after commencing albendazole, the patient developed acute chest pain due to rupture of the pulmonary cyst, with subsequent seroconversion for Echinococcus granulosus. A literature review identified four reports of ruptured pulmonary hydatid cysts during albendazole therapy, including a total of nine patients. Eight of 9 cases reported rupture of pulmonary cysts, all within 3 weeks of albendazole commencement, which was speculated to be due to decreased cuticular membrane pressures.