title: Ruptured pulmonary hydatid cyst with anaphylactic shock and pneumothorax.
abstract: Hydatid cyst is a disease caused by a parasitic tapeworm, Echinococcus granulosus, and most commonly involves liver and lung. Ruptured pulmonary hydatid cyst can present a diagnostic challenge, and radiograph can be inconclusive. Anaphylactic reaction is a rare complication of ruptured pulmonary hydatid cyst. A 22-year-old male came to our emergency department in shock with symptoms of shortness of breath and altered mental status from the previous day. Radiograph showed a thin-walled circular translucent area in the right upper lung field, which was misdiagnosed as pneumothorax, and an intercostal chest tube was inserted. After 5 days, repeat radiograph revealed a cavity with an air/fluid level. The chest tube was removed and contrast-enhanced computed tomogram showed a cavity with water-lily sign, which suggests ruptured hydatid cyst. Immunoglobin-G enzyme-linked immunosorbent assay for Echinococcus was positive. The patient responded well to treatment with crystalloid infusion, supplemental oxygen, and albendazole, and then underwent surgery. Anaphylactic reaction due to rupture of a hydatid cyst is rare, but hydatid disease should be suspected in patients from areas where Echinococcus is endemic.
authors.affiliation: Department of Tuberculosis and Chest Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Uttar Pradesh, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shameem
authors.forename: Jamal
authors.initials: J
authors.lastname: Akhtar
authors.forename: Rakesh
authors.initials: R
authors.lastname: Bhargava
authors.forename: Zuber
authors.initials: Z
authors.lastname: Ahmed
authors.forename: Nafees Ahmad
authors.initials: NA
authors.lastname: Khan
authors.forename: Ummul
authors.initials: U
authors.lastname: Baneen
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000707:Anaphylaxis / Q000469:parasitology*; D000871:Anthelmintics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004445:Echinococcosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000601:surgery; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D015766:Albendazole