Abstract
Echinococcus granulosus hydatid disease is an infestation by a parasite, commonly of the liver and lungs. Multicomponent and cardiac thoracic involvement are rare and diagnostic challenges. A report of a shortness-of-breath-impacted, chest-tightness-impacted man aged 80 years who presented with grape-like vesicles expectorated is described. The serological assay was echinococcosis-positive. Transthoracic echocardiography and contrast-enhanced CT revealed disseminated thoracic hydatid disease in the lungs, pleura, mediastinum, pericardium, and right ventricle. The patient was referred for cardiothoracic surgery. The case highlights the importance of extensive imaging in the diagnosis of rare presentations of hydatid disease and the need for increased clinical suspicion in endemic areas. Monitoring hydatid disease early in patients with cystic expectoration and clear chronologia is important, especially in endemic areas, and should be followed promptly with serological tests and imaging. In this case, echocardiography was useful in demonstrating intracardiac involvement, while CT imaging was able to establish the degree of thoracic dissemination. Both modalities were essential in assessing the extent of disease dissemination and the potential surgical plan. Clinicians should have hydatid disease on their differential diagnosis in patients with cystic expectoration without socratic/normal history and risk factors, as early evaluation is important in how they may care for the patient.