{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:12Z","timestamp":1756361412192,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,15]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>A previously healthy 13-year-old boy was brought to the emergency department in critical condition following a fainting episode, showing signs of cyanosis, acute respiratory distress and a weak radial pulse. Epinephrine and oxygen supplementation were administered in the local Paediatric Emergency Service. A history of vomiting clear fluid and \u2018grape skin\u2019 was reported by the teacher.<\/jats:p>\n               <jats:p>After clinical and chest X-rays were performed, a large air-fluid cavity was revealed in the upper and middle fields of the right lung. A contralateral infiltrate was also present as well. After a CT thorax scan, a diagnosis of cystic echinococcus was made after a CT thorax scan. Blood tests and serological tests for echinococcus were negative.<\/jats:p>\n               <jats:p>The child received conservative treatment for several days, which included oxygen supplementation, antibiotics, aerosol therapy and kinesitherapy. This approach helped to open the primary bronchi and trachea, facilitating a reduction in the size of the cavity. Albendazole was administered 5\u2009days prior to the surgical intervention.<\/jats:p>\n               <jats:p>Surgical intervention consisted of endocystectomy and capitonnage, conserving the parenchyma. Spillage during the rupture, which caused bronchial obstruction from degrading scolexes of the contralateral side, was managed through flexible bronchoscopy.<\/jats:p>\n               <jats:p>The patient experienced a favourable outcome with full clinical and radiological resolution after a 6-month course with albendazole and supportive therapy.<\/jats:p>","DOI":"10.1136\/bcr-2025-264949","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:25:15Z","timestamp":1751279115000},"page":"e264949","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rupture of Echinococcus granulosus leading to severe hypoxia: preoperative and postoperative management"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9942-2929","authenticated-orcid":false,"given":"Melpomeni","family":"Bizhga","sequence":"first","affiliation":[{"name":"Pediatrics, Qendra Spitalore Universitare 'Nene Tereza\u2019, Tirana, Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saimir","family":"Heta","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Qendra Spitalore Universitare 'Nene Tereza\u2019, Tirana, Tirana County, Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"2025082722514460000_18.6.e264949.1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.actatropica.2013.08.002","article-title":"Canine echinococcosis: global epidemiology and genotypic diversity","volume":"128","author":"Carmena","year":"2013","journal-title":"Acta Trop"},{"key":"2025082722514460000_18.6.e264949.2","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/BF00932250","article-title":"Incomplete development of larval Echinococcus multilocularis (Cestoda: Taeniidae) in spontaneously infected wild 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