Fatima Ismail, Ayesha Mansoor.
An Unusual Presentation of Hydatid Cysts in a Four Year Old Child.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;19(2):97-101.

We report case of 4 years old vaccinated girl weighing 13 kg who was admitted in our hospital with complaints of fever & cough off and on for last 1 year. This was accompanied with difficulty in breathing for past 1 week only. Her Chest x-rays demonstrated left sided lobar consolidation. She responded to antibiotics but complete resolution of the consolidation was not observed. On repeat chest X ray on day 7, the radiological findings were same, following which an ultrasound chest was done which shows cystic lesion on left side of the chest and another cyst in upper abdomen, we confirmed this with computerized tomography (CT) chest and CT abdomen. Serological tests for hydatid cyst (indirect haemaglutination) were positive. A provisional diagnosis of hydatid cyst was made and the child was put on albendazole. A surgical consult was also taken. After 6 months of albendazole off and on, due to non-compliance, surgery was done. Cyst of liver of removed successfully and albendazole was continued. Child responded and repeat radiological survey showed a marked decrease in the size of the cyst and at present the child is clinically well and now going regularly to school. We are reporting this case as it presented in an unusual manner and the child had been seen by a number of physicians, and given various antibiotics, with no response and finally the parents brought the child to our hospital. The hydatid cyst in this young girl was missed out because it was not considered in the differential diagnosis of persistent breathlessness.

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