title: Anaphylactic shock ensuing therapeutic puncture of an echinococcal cyst.
abstract: Cystic echinococcosis (CE) is a widespread zoonosis. For treating single echinococcal cysts during the last decades, therapeutic puncture of the cyst, aspiration, injection of a scolicide, and re-aspiration (PAIR) has been established as a minimal-invasive alternative method to surgery. A recent review on the complications of therapeutic cyst punctures has shown that dangerous complications occur much less frequently than previously assumed. A case is described where an allergic acute bronchospasm and arterial hypotension led to a life-threatening shock immediately after echinococcal cyst puncture. Fortunately, the situation could be managed by an experienced and well-equipped anesthesiology team. Life-threatening allergic phenomena after puncture of echinococcal cysts may occur less frequently than generally assumed; nevertheless, they must be taken into account, and precautions must be taken to manage serious adverse events.
authors.affiliation: Tropical Medicine Unit, Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Federal Republic of Germany, Joachim.Richter@med.uni-duesseldorf.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Richter
authors.forename: Efim
authors.initials: E
authors.lastname: Profis
authors.forename: Martha C
authors.initials: MC
authors.lastname: Holtfreter
authors.forename: Arzu
authors.initials: A
authors.lastname: Orhun
authors.forename: Irmela
authors.initials: I
authors.lastname: Müller-Stöver
authors.forename: Hülya
authors.initials: H
authors.lastname: Dedelen
authors.forename: Ralf
authors.initials: R
authors.lastname: Kubitz
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000707:Anaphylaxis / Q000209:etiology* / Q000628:therapy; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D000923:Anticestodal Agents / Q000627:therapeutic use; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000628:therapy*; D004446:Echinococcus / Q000276:immunology; D005260:Female; D006801:Humans; D011223:Praziquantel / Q000627:therapeutic use; D011677:Punctures / Q000009:adverse effects*; D013396:Suction; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth; D000923:Anticestodal Agents; D011223:Praziquantel; D015766:Albendazole