Pulmonary hydatid cyst presenting with altered consciousness in a 19-year-old Afghan migrant: a case report and review of the literature

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Hydatid disease is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus. Clinical manifestations vary based location and size of the cyst. While pulmonary hydatid cysts are well-documented, neurological presentations such as altered consciousness are exceptionally rare and have never been reported in Afghan migrants. This case highlights a novel clinical manifestation in a vulnerable population with limited healthcare access, underscoring the urgent need for systematic screening and heightened clinical awareness in host countries. This study details the case of a 19-year-old Afghan woman with a left pulmonary hydatid cyst who presented with dyspnea, chest pain, myalgia, and decreased consciousness. The diagnosis was established based on radiological findings and clinical presentation. The patient underwent complete surgical excision of the cyst and was discharged in a stable condition after an uneventful postoperative period. She was followed up for 6 months, with no evidence of cyst recurrence and complete clinical recovery. Additionally, a focused review of the literature identified 15 case reports of hydatid cyst in immigrant populations. Although rare in some regions, pulmonary hydatid cysts remain a critical differential diagnosis in migrants from endemic areas. This case underscores the importance of timely diagnosis, precise imaging, and a multidisciplinary therapeutic approach combining surgical intervention and pharmacotherapy. A Comparative analysis of the existing literature demonstrates that combined treatment yields favorable clinical outcomes and reduces recurrence risk. Heightened clinical awareness, particularly in migrant populations is essential to prevent severe complications. Most importantly, it exposes a systemic gap: migrants from high-risk areas are rarely screened for echinococcosis. We urge health systems to incorporate routine serology and chest imaging into migrant health protocols, a low-cost, high-impact intervention that can prevent avoidable complications and advance health equity.