Spontaneous bronchial rupture of a large pulmonary cyst in a pediatric patient: a diagnostic review

Pulmonary hydatid disease remains a significant clinical challenge in endemic areas, particularly in children, where the lungs are the predominant site of involvement. We report a rare case of a 10-year-old girl presenting with a large pulmonary hydatid cyst that underwent spontaneous rupture into the bronchial tree, initially misdiagnosed as a lung abscess. The clinical progression included persistent cough, high-grade fever, and vomiting of yellowish fluid, eventually leading to respiratory distress. Imaging revealed a cavitary lesion with irregular walls and fibrous capsule, suggestive of a ruptured cyst. Surgical management involved thoracotomy, careful extraction of cystic contents, closure of bronchial openings, and cavity padding using a platelet-rich hemostatic sponge. Postoperative recovery was uneventful, with long-term imaging showing partial lung remodeling and perfusion deficits. This case underscores the diagnostic pitfalls associated with ruptured pulmonary hydatid cysts in pediatric patients and highlights the importance of early radiological evaluation and tailored surgical intervention for optimal outcomes.