Background: Hydatidosis (hydatid disease) is a serious human cestode infection, caused by ingested egg of  Echinococcus. It is endemic mostly in sheep or cattle-raising areas of the world including India. This disease usually presents in adulthood and relatively uncommon in pediatric population. Co-involvement of lungs and liver, known as hepatopulmonary hydatidosis (HPH) is  found in around 6% cases of pediatric hydatid disease and very few cases have been reported previously from India.
Case summary: In this case series we reported three 6 to 8 years old children from rural background with multiple hydatid cyst involving lungs and liver, who presented with non-specific respiratory or gastrointestinal symptoms mimicking pneumonia or abdominal pathology. Chest X-ray followed by USG and CECT abdomen and thorax showed multiple cystic lesions of different dimensions in right middle and lower lobe of lungs along with right and left lobe of liver. Echinococcus IgG level in serum was high in all the children. They were treated with oral albendazole along with surgical interventions successfully with operative findings of ruptured cyst with hydatid sand and daughter cysts.
Conclusion: Rarity of the pediatric hydatid disease involving both lungs and liver prompted us to report three children from rural background with multiple hydatid cyst in both liver and lung.