Six patients of pulmonary hydatid disease who developed rupture of their cysts upon treatment with albendazole started prior to percutaneous aspiration (n=4) and /or surgery (n=2) are presented. The patients had been put on albendazole for sterilization of the cysts prior to the procedure. The rupture resulted is sudden cough (n= 6), breathlessness (n=3), chest pain ( n= 2) and wheezing (n= 2) accompanied by expectoration of a salty fluid containing whitish membrane like structures. The expectorated material was found to contain hydatid scolices in each case. The rupture alongside continued albendazole therapy was curative in 2 cases and a regrowth was observed in 5 cysts. No spillage hydatidosis was seen. Albendazole therapy can cause a rupture in some patients with pulmonary hydatid disease and should be suspected in any such patient who presents with sudden onset respiratory symptoms. The rupture may be curative in some but the patients need to be followed for regrowth or development of spillage induced secondary hydatidoses.
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