Hydatid Cyst in a Post-Tuberculosis Patient: A Persistent Pulmonary Puzzle - A Case Report

Pulmonary tuberculosis and hydatid cyst are two distinct pathologies with vastly different etiologies and management approaches, yet they share common risk factors and pulmonary involvement. This rare and unique case of a hydatid cyst occurring in a post-tuberculosis patient adds to the limited literature and highlights the diagnostic and therapeutic challenges involved. A 28-year-old female presented with shortness of breath, productive cough, and copious hemoptysis. Clinical examination revealed decreased breath sounds on the right side. Her past medical history was significant for treating pulmonary tuberculosis, which was completed 1 year prior. Initial suspicion of TB reactivation was ruled out by negative AFB sputum analysis. Imaging revealed a well-defined pulmonary mass, confirmed as a hydatid cyst on CT scan. The patient was managed with oxygen, IV antibiotics (cefoperazone/sulbactam), albendazole, corticosteroids, and supportive care, resulting in symptom improvement. Surgical intervention is planned for definitive management. This case is important as it highlights that in a post-TB patient with ongoing respiratory symptoms, a hydatid cyst must be considered as a differential diagnosis, especially in regions where hydatid disease is prevalent. Diagnosing a hydatid cyst can be challenging, as both TB and hydatid cysts present with similar symptoms. Therefore, accurate diagnosis requires a multidisciplinary approach involving medical, radiological, and surgical interventions. Additionally, this case raises public awareness about the symptom overlap between hydatid cyst and TB, which can aid in early detection.