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Multiple pulmonary nodules: diagnosis in an young afebrile patient

Q1: What is the diagnosis?
Pulmonary hydatid disease.

Q2: What is the differential diagnosis?
Differential diagnosis of multiple pulmonary nodules includes neoplastic, infective, immunological, and vascular causes (see box 1).

Box 1: Differential diagnosis of multiple pulmonary nodules Metastasis. Abscess. Hydatid cyst. Fungal infection. Wegener’s granulomatosis. Rheumatoid nodule. Septic embolus. Arteriovenous malformation.

 

Q3: How does this condition present?
The majority of intact pulmonary cysts are known to produce no symptoms or are occasionally responsible for a non-productive cough or minimal haemoptysis.¹ However, when the cyst ruptures, an abrupt onset of cough, haemoptysis, sputum, fever, chest pain, expectoration, and life threatening anaphylactic reaction may develop.² The expectoration of membrane and/or hydatid sand is a clinically diagnostic indicator of ruptured hydatid cyst.

Other symptoms may arise such as Horner’s syndrome from superior sulcus cysts, bone pain from posterior mediastinal cysts, dyspnoea from tracheal compression, haemorrhage due to erosion of great vessels, and tension pneumothorax.¹

Q4: What other tests should be performed?
These include serological tests, sputum examination, and abdominal sonography. Serological studies in hydatid disease includes complement . . . [Full text of this article]

Relevant Article

Multiple pulmonary nodules: diagnosis in an young afebrile patient

K S Sodhi, M Kang, M Gulati, and S Suri
Postgrad. Med. J. 2003 79: 62. [Extract] [Full Text] [PDF]