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Harefuah 2016-Nov

[RED HERRING COMPLAINTS IN AN EIGHTEEN YEARS OLD FEMALE WITH A HYDATID CYST OF THE LUNG].

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Nasser Nadim

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BACKGROUND

Brain and eye hydatid cysts are early symptomatic, as opposed to those developing in other organs, including lungs, where they remain asymptomatic through adolescence, even to adulthood, due to their slow growth. Hence, discovering that patients have lung hydatid cyst occurs, frequently, during random chest imaging. Up to thirty percent of pulmonary echinococcal cysts may rupture spontaneously, after chest or abdominal trauma. The main lung hydatidosis complaints, such as dyspnea and chest pain, are caused by the reduction of the functional area of the lung, expectoration of the tapeworm cystoides into the bronchial tree, or by compression of surrounding structures. When a hydatid cyst ruptures and its contents are poured into the pleural cavity or into the bronchi, the patient's condition will worsen deeply with severe hemoptysis, fever and chills, or anaphylactic shock. Therefore, treatment must be performed early upon the disclosure of these ominous findings. Our case report emphasizes that even if a cyst in the lung is symptomatic, it is frequently not diagnosed early, or might be completely missed by experienced clinicians. Moreso, when symptoms which are not recognized in the medical literature, such as symptoms of pulmonary hydatidic disease, exist as a "red herring" which blind the clinician from seeing the primary disease. Delay in diagnosis could also ostensibly occur due to physician's adherence to previous medical history, as he would think that a serious complaint, such as shortness of breath, is associated with health problems in the past, although, actually it is a result of a different diagnosis: a hydatid lung cyst.

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