Recurrent anaphylactic shock as a manifestation of echinococcosis: Report of a Case

Abstract

Hydatid disease, caused by the cestode Echinococcus granulosus, is common in Mediterranean regions, being highly endemic in Greece. Depending on its size, an intact hydatid cyst may be "silent" or may cause symptoms from compression of adjacent organs. Rupture of a hydatid cyst commonly gives to allergic phenomena, which can include anaphylactic shock. A case is presented in which there was a two-year history of recurrent anaphylactic shock due to small, incomplete ruptures of hydatid cyst. The case emphasizes the potentially life-saving importance of early diagnosis of hydatid cyst.

Pulmonary echinococcosis

“…Fever and acute hypersensitivity reactions ranging from urticaria and wheezing to life-threatening anaphylaxis may be the principal manifestations. Although allergic episodes may develop after cyst rupture, fatal anaphylaxis is uncommon [20,21].…”

Hydatid Disease: Current Status and Recent Advances

“…Cyst rupture into the peritoneum causes immediate life-threatening anaphylaxis and if the person survives, the scoleces implant on the peritoneal surface resulting in extensive peritoneal hydatidosis. 19,20 A cyst can rupture into the pleural cavity or lung and can establish cystobronchial fistula. 15 Rarely, cyst can grow on to the skin along a sinus tract following surgery or percutaneous drainage of the cyst.…”

Immunological Characteristics of Recurrent Echinococcosis-Induced Anaphylactic Shock

“…With the exception of one other case of recurrent anaphylactic shock as a result of echinococcosis in Greece reported in 1986, 11 ours is the only other study to date. Although both patients in our study were admitted to our hospital because of systemic echinococcosis, the locations from which the cysts were removed in the first surgery were distinct (right lung versus abdomen); however, both had pulmonary and liver echinococcosis classified as type CE2 cysts.…”