INTRAPLEURAL RUPTURED HYDATID CYST OF LIVER PRESENTED AS EOSINOPHILIC PLEURAL EFFUSION: CASE REPORT

Eosinophilic pleural effusions (EPE) are rare with an estimated incidence of 7.2% of all pleural effusions. EPE due to echinococcosis is exceptionally described in the literature. Pleural echinococcosis is almost always secondary to a ruptured primary lung cyst. Intrathoracic rupture of hepatic hydatid cyst (HC) is a rare clinical entity the rupture into the pleural cavity is less common than in the bronchial tree. We report a case of a 72 year old patient, presented with dyspnea, the chest X-ray showed a right-sided pleural effusion. The initial diagnostic process included two thoracentesis which yield eosinophilic pleural effusions. A transthoracic ultrasound showed cystic formations in the pleura, in addition to an abdominal collection with classic ultrasound images of water-lily sign and serpent sign. CT features suggested ruptured hepatic hydatid cyst in the pleura. Surgical intervention was indicated with postoperative chemotherapy.