Pulmonary hydatid cyst disease mimicking necrotizing pneumonia in a child with leukocytoclastic vasculitis

The diagnosis and management of pulmonary hydatid cyst disease represents an important clinical problem in countries of the world that are endemic to echinococcal infection. Atypical clinical and radiologic findings including multiple cavitary lesions in the lung and pleural effusion may lead to misdiagnosis or delay in diagnosis in these patients. We report a patient who was followed up in our hospital with rashes and, clinical and radiologic findings of necrotizing pneumonia in whom there was no response to broad spectrum antibiotherapy. Lung computed tomography showed multiple thick-walled cystic lesions and pleural effusion and the diagnosis of pulmonary hydatid cyst disease was confirmed by surgical and serologic examinations. Antibiotic treatment was changed to albendazole 10 mg/kg/day. There was no liver involvement in terms of cyst hydatid disease with ultrasonographic examination. Skin biopsy showed leukocytoclastic vasculitis. Complete clinical and radiologic improvement was achieved in three months and albendazole treatment lasted six month.