[Anaphylactic shock caused by rupture of an echinococcal cyst in a 25-year-old asylum seeker from Georgia].
METHODS
A 25-year-old asylum seeker from Georgia was admitted to hospital with acute right upper quadrant abdominal pain, vertigo, dyspnea, generalized urticaria and positive shock index (blood pressure 80/40 mmHg, pulse 120/min) several minutes after eating an instant soup.


METHODS
Laboratory investigations showed a slight increase of the eosinophilic cell count and GOT and GPT activities. Abdominal ultrasound scan (USS) and computed tomography (CT) revealed a multivesicular septated cystic space-occupying lesion of the right liver lobe (segment VII, 13 x 9 x 8 cm) and perihepatic fluid.


METHODS
Intravenous steroids, H 1 and H 2 antagonists and fluid were given. Emergency laparatomy with endocystectomy was performed. A 3-month course of antihelmintic therapy with albendazole was applied. During follow-up up to one year after surgery the patient did well. Ultrasonography and computed tomography showed only a small residual defect in the right liver lobe where the cyst had been removed.


CONCLUSIONS
In patients from echinococcosis-endemic regions who develop an anaphylactic reaction, a ruptured Echinococcus granulosus cyst should be considered in the differential diagnosis. Abdominal ultrasonography and serology (to be noted: substantial rate of false negative results!) should be performed.
Köppen
S
S
Medizinische Klinik, Klinikum Minden.
Wejda
B
B
Dormann
A
A
Seesko
H
H
Huchzermeyer
H
H
Junghanss
T
T
D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000628:therapy; D005500:Follow-Up Studies; D005846:Georgia (Republic) / Q000208:ethnology; D005858:Germany; D006801:Humans; D008297:Male; D012036:Refugees; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography