Tension pyopneumothorax due to a ruptured pulmonary echinococcal cyst.

cin as well as 6 months of daily albendazole 400 mg b.i.d. for the first 3 weeks of every month. A week later he was readmitted due to recurrent syncope and hypotension. He had an elevated JVP and no breath sounds on the right side. There was also marked new eosinophilia. CT demonstrated a new massive right pleural effusion compressing the superior vena cava and right heart and necessitating emergency drainage of what was an overt empyema with a pH of 6.8 ( fig. 2 a). During hospitalization he reA 38-year-old otherwise healthy man presented to the emergency department with a 3-day history of fever, dyspnea, pleuritic chest pain, and hemoptysis. CT scan suggested a hydatid lung cyst ( fig. 1 ) without evidence of other organ involvement. Sputum microscopy revealed echinococcal protoscolices of various maturations, and sputum cultures yielded Acinetobacter baumanii. The patient refused surgery and was discharged for medical therapy with 2 weeks of oral clindamycin and levofloxaPublished online: August 4, 2012