A 31-year-old Syrian pregnant (25-week duration) patient who was managed as a case of bronchial asthma for one year because of chronic cough and progressive breathlessness presented to the Accident and Emergency Department at Hamad General Hospital, Doha, with cough and shortness of breath. On the day of admission, she coughed large amount of yellowish watery material which was salty and sour in taste. She was found by radiological investigations to have multiple giant hydatid cysts (three in the lungs and one in the liver), with ruptured cyst in the left lung. We report here an unusual case of giant multiple pulmonary hydatidosis localized in the lungs and masquerading as bronchial asthma in a pregnant lady. The case represents an uncommon situation of a common disease of rupture of hydatid cyst of the lung in a pregnant lady in her 3rd trimester. 1. Introduction Human echinococcosis was first described in ancient times by Hippocrates, as “cysts full of water” in a human liver [1, 2]. Al-Rahzes, the famous physician, subsequently wrote on hydatid cyst of the liver about thousand years ago [3]. Currently, hydatid disease is classified among the most neglected parasitic diseases [4, 5]. Infection with Echinococcus granulosus is the most common form of echinococcal infection in humans. The parasite involves dogs (the definitive hosts) and sheep (the intermediate hosts), and in the definitive canine host, the adult worm resides in the intestine, and its eggs, or oncospheres, are released into the feces [6]. Because humans play the same role of intermediate hosts in the tape warm life cycle as sheep, humans also become infected by ingesting tape warm eggs from an infected carnivore [7]. This occurs most frequently when individuals handle or contact infected dogs or other infected carnivores or inadvertently ingest food or drink contaminated with fecal material containing tape worm eggs [8]. The eggs can also be inhaled, causing primary lung disease [9]. When an oncosphere is ingested by a suitable intermediate host, it penetrates the intestinal wall and migrates by way of the portal circulation to the liver, where most oncospheres are deposited. However, some of the organisms are not filtered by the liver and are trapped in the pulmonary circulation [10]. An alternative path to the lung is the intestinal lymphatics, with entry into the circulation by way of the thoracic duct. A small proportion of oncospheres may be disseminated systemically and may infect any organ, including the central nervous system, myocardium, and bone. Within the chest,
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