The period of initial cyst growth is usually asymptomatic, and it is not rare to discover the lesion during a radiologic examination performed for other reasons. Nonspecific symptoms as such as chest pain, cough, hemoptysis, dyspnea, allergic reactions, and fever are evident in some cases.14 The presence of vomica, acute respiratory failure, massive hemoptysis, anaphylactic shock, cardiovascular collapse, empyema, PNX, and pleural effusion are life-threatening conditions and usually indicate a cyst or cavity rupture.15 These are rarer than nonspecific symptoms. In particular, direct contact of the HC layer with airways sets the conditions for the onset of tension PNX. In our case, the patient was referred to our attention for the worsening of a 3-week history of nonspecific symptoms (ie, cough, wheezing, chest pain, and fever). Final diagnosis was made only by additional examinations; this emphasizes the insidious clinical presentation of hydatid lung disease.