ABSTRACT
Echinococcosis Echinococcus granulosus, the dog or wolf tapeworm, can produce pleural effusion by transdiaphragmatic rupture of a liver or splenic hydatid cyst, rupture of a pulmonary hyda tid cyst, involvement of the pleura by a primary pleural cyst, and by diaphragmatic irrita tion resulting in a sympathetic effusion. Fortunately, less than 5% of hydatid cysts rupture. When rupture occurs, it usually presents as an acute illness with shock. Demonstration in pleural fluid of the classic scolices with hooklets is diagnostic. Treatment involves thoracotomy with closure of any fistula, cyst excision, and systemic antiparasitic therapy with mebendazole or albendazole.
