title: [Anaphylactic shock caused by rupture of an echinococcal cyst in a 25-year-old asylum seeker from Georgia].
abstract: 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.
authors.affiliation: Medizinische Klinik, Klinikum Minden.
authors.forename: S
authors.initials: S
authors.lastname: Köppen
authors.forename: B
authors.initials: B
authors.lastname: Wejda
authors.forename: A
authors.initials: A
authors.lastname: Dormann
authors.forename: H
authors.initials: H
authors.lastname: Seesko
authors.forename: H
authors.initials: H
authors.lastname: Huchzermeyer
authors.forename: T
authors.initials: T
authors.lastname: Junghanss
mesh_terms: 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