Primary Pleural Hydatidosis Revealed by Acute Respiratory Distress: A Rare Extrapulmonary Manifestation of Echinococcosis

Pleural hydatidosis is a rare manifestation of echinococcosis, most often secondary to the rupture of a hepatic or pulmonary cyst into the pleural cavity. It provokes a significant inflammatory response, frequently leading to acute respiratory compromise. The main pathophysiological mechanisms include pleural effusion, floating hydatid membranes, and compressive cystic expansion. Diagnosis relies heavily on imaging, particularly chest CT, which can delineate the extent of both pleural and hepatic involvement. We report a representative case of compressive pleural hydatidosis with concomitant hepatic localization, revealed by acute respiratory distress and managed through antiparasitic therapy, non-invasive ventilation, and surgical intervention. This case underscores the importance of rapid recognition and a multidisciplinary approach to avoid severe complications in advanced hydatid disease.