Anaphylactic Shock Following Spontaneous Rupture of Pulmonary Hydatid Cyst: A Case Report
Abstract
We present a case of a 31-year-old rural Iranian man with no prior medical history who developed sudden-onset dyspnea, generalized urticaria, and hypotension. Based on clinical findings and unstable vital signs, anaphylactic shock was suspected and immediate treatment with oxygen, intravenous fluids, and intramuscular epinephrine was initiated. Following stabilization, a spiral chest CT scan revealed a large hydatid cyst with lower lobe collapse, inner membrane detachment near the pericardium, pericardial effusion, and hydropneumothorax. The patient was referred for thoracic surgery, which was successfully performed. He was discharged in stable condition with albendazole therapy and follow-up. Although rare, anaphylactic shock due to hydatid cyst rupture should be considered in endemic regions. In the emergency setting, prompt differentiation from other acute conditions such as asthma, angioedema, or pulmonary embolism is essential to avoid delays in life-saving interventions. Prompt administration of epinephrine and surgical management are essential for favorable outcomes.
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3. Aydin Y, Ulas AB, Ahmed AG, et al. Pulmonary hydatid cyst in children and adults: diagnosis and management. Eurasian J Med. 2022;54(1):133 140.
4. Jalayeri MH, Zakariaei Z, Fakhar M, et al. Ruptured pulmonary hydatid cyst and lophomoniasis comorbidity in a young man: a rare case. Oxf Med Case Reports. 2023;2023(3): omad023.
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8. Akbulut S, Ozdemir F. Intraperitoneal rupture of the hydatid cyst: four case reports and literature review. World J Hepatol. 2019;11(3):318-329.
9. Koc C, Akbulut S, Sahin TT, et al. Intraperitoneal rupture of the hydatid cyst disease: single center experience and literature review. Ulus Travma Acil Cerr Derg. 2020; 26(5): 789 797.
10. Öztorun Cİ, Demir S, Güney D, et al. An unsolved problem in developing countries: hydatid cysts in children. Pediatr Surg Int. 2021;37:1235 1241.
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12. Sarkar M, Pathania R, Jhobta A, et al. Cystic pulmonary hydatidosis. Lung India. 2016; 33(2):179-191.
13. Gupta N, Katiyar R, Singh VK. Case of anaphylactic shock after ruptured hydatid cyst of liver: A nightmare to emergency physicians. J Emerg Trauma Shock. 2020;13(2):171 172.
14. Hill A. Point of care ultrasound diagnosis of pulmonary hydatid cyst rupture in a pediatric patient. Am J Emerg Med. 2021;39:268.e5 268.e8.
15. Li S, Zhang W, Li T, et al. Identification of IgE and IgG1 specific antigens in Echinococcus granulosus cyst fluid. Braz J Med Biol Res. 2017;50(5):e6071.
16. Fanne RA, Khamaisi M, Mevorach D, et al . Spontaneous rupture of lung echinococcal cyst causing anaphylactic shock and respiratory distress syndrome. Thorax. 2006;61(6):550.
17. Zakariaei Z, Fakhar M, Sharifpour A, et al. Anaphylactic shock due to ruptured pulmonary hydatid cyst in a young patient from Iran. Ann Med Surg (Lond). 2021;68:102675.
18. Mohammed A, Malki K, Mellagui Y, et al. Anaphylactic shock due to traumatic rupture of pulmonary hydatid cyst: case report. Int J Surg Case Rep. 2021;81:105660.
19. Avaro JP, Thefenne H, Brioude G, et al. [Role of surgery in the management of pulmonary parasitosis]. Rev Pneumol Clin. 2012;68(2):117 22.
20. Rouhani S, Parvizi P, Spotin A. Using specific synthetic peptide (p176) derived AgB 8/1 kDa accompanied by modified patient’s sera: a novel hypothesis to follow up of Cystic echinococcosis after surgery. Med Hypotheses. 2013; 81(4): 557 60.
21. Karimi M, Rostami A, Spotin A, et al. Ruptured pulmonary hydatid cyst: a case report. J Parasit Dis. 2017;41(3):899 902.
22. Lupia T, Corcione S, Guerrera F, et al. Pulmonary echinococcosis or lung hydatidosis: a narrative review. Surg Infect (Larchmt). 2021;22(5):485 495.
23. Brown JC, Simons E, Rudders SA. Epinephrine in the Management of Anaphylaxis.J Allergy Clin Immunol In Pract. 2020; 8(4): 1186 1195.
24. Ahmed OF, Hamodat OM, Abdullah F, et al. Capitonnage method for surgical management of pulmonary hydatid cysts: A retrospective study. Barw Med J. 2023; doi.org/10.58742/bmj.v1i2.26.
25. Belli S, Akbulut S, Erbay G, Kocer NE. Spontaneous giant splenic hydatid cyst rupture causing fatal anaphylactic shock: a case report and brief literature review. Turk J Gastroenterol. 2014;25(1):88 91.
26. Dehkordi AB, Sanei B, Yousefi M, et al. Albendazole and treatment of hydatid cyst: review of the literature. Infect Disord Drug Targets. 2019; 19(2): 101 104.
2. Garoma A. Epidemiology of Hydatidosis in Ethiopia. J Nurs Health Care. 2022; 7(3):01 6.
3. Aydin Y, Ulas AB, Ahmed AG, et al. Pulmonary hydatid cyst in children and adults: diagnosis and management. Eurasian J Med. 2022;54(1):133 140.
4. Jalayeri MH, Zakariaei Z, Fakhar M, et al. Ruptured pulmonary hydatid cyst and lophomoniasis comorbidity in a young man: a rare case. Oxf Med Case Reports. 2023;2023(3): omad023.
5. Aghajanzadeh M,Jafroudi EH, Foumani AA, et al. Postoperative recurrence of cystic hydatidosis: Management and outcome. Int J Life Sci. 2022;10(2):101 8.
6. Li T, Li J, Gao X, et al. Immunological mechanisms of anaphylactic shock in patients with cystic echinococcosis. Parasit Vectors.2017;10:283.
7. Özdemir T, Arıkan A. Pulmonary hydatid cyst rupture in childhood: Presentation, diagnosis and treatment strategies. Turk Arch Pediatr. 2013;48(4):323 6.
8. Akbulut S, Ozdemir F. Intraperitoneal rupture of the hydatid cyst: four case reports and literature review. World J Hepatol. 2019;11(3):318-329.
9. Koc C, Akbulut S, Sahin TT, et al. Intraperitoneal rupture of the hydatid cyst disease: single center experience and literature review. Ulus Travma Acil Cerr Derg. 2020; 26(5): 789 797.
10. Öztorun Cİ, Demir S, Güney D, et al. An unsolved problem in developing countries: hydatid cysts in children. Pediatr Surg Int. 2021;37:1235 1241.
11. Saǧ S, Şalcı G, Sarıhan H, et al. Surgical Approach to Childhood Hydatid Cyst Disease: Experience of Two Centers. J Pediatr Inf. 2022;16(3):e163 e1677.
12. Sarkar M, Pathania R, Jhobta A, et al. Cystic pulmonary hydatidosis. Lung India. 2016; 33(2):179-191.
13. Gupta N, Katiyar R, Singh VK. Case of anaphylactic shock after ruptured hydatid cyst of liver: A nightmare to emergency physicians. J Emerg Trauma Shock. 2020;13(2):171 172.
14. Hill A. Point of care ultrasound diagnosis of pulmonary hydatid cyst rupture in a pediatric patient. Am J Emerg Med. 2021;39:268.e5 268.e8.
15. Li S, Zhang W, Li T, et al. Identification of IgE and IgG1 specific antigens in Echinococcus granulosus cyst fluid. Braz J Med Biol Res. 2017;50(5):e6071.
16. Fanne RA, Khamaisi M, Mevorach D, et al . Spontaneous rupture of lung echinococcal cyst causing anaphylactic shock and respiratory distress syndrome. Thorax. 2006;61(6):550.
17. Zakariaei Z, Fakhar M, Sharifpour A, et al. Anaphylactic shock due to ruptured pulmonary hydatid cyst in a young patient from Iran. Ann Med Surg (Lond). 2021;68:102675.
18. Mohammed A, Malki K, Mellagui Y, et al. Anaphylactic shock due to traumatic rupture of pulmonary hydatid cyst: case report. Int J Surg Case Rep. 2021;81:105660.
19. Avaro JP, Thefenne H, Brioude G, et al. [Role of surgery in the management of pulmonary parasitosis]. Rev Pneumol Clin. 2012;68(2):117 22.
20. Rouhani S, Parvizi P, Spotin A. Using specific synthetic peptide (p176) derived AgB 8/1 kDa accompanied by modified patient’s sera: a novel hypothesis to follow up of Cystic echinococcosis after surgery. Med Hypotheses. 2013; 81(4): 557 60.
21. Karimi M, Rostami A, Spotin A, et al. Ruptured pulmonary hydatid cyst: a case report. J Parasit Dis. 2017;41(3):899 902.
22. Lupia T, Corcione S, Guerrera F, et al. Pulmonary echinococcosis or lung hydatidosis: a narrative review. Surg Infect (Larchmt). 2021;22(5):485 495.
23. Brown JC, Simons E, Rudders SA. Epinephrine in the Management of Anaphylaxis.J Allergy Clin Immunol In Pract. 2020; 8(4): 1186 1195.
24. Ahmed OF, Hamodat OM, Abdullah F, et al. Capitonnage method for surgical management of pulmonary hydatid cysts: A retrospective study. Barw Med J. 2023; doi.org/10.58742/bmj.v1i2.26.
25. Belli S, Akbulut S, Erbay G, Kocer NE. Spontaneous giant splenic hydatid cyst rupture causing fatal anaphylactic shock: a case report and brief literature review. Turk J Gastroenterol. 2014;25(1):88 91.
26. Dehkordi AB, Sanei B, Yousefi M, et al. Albendazole and treatment of hydatid cyst: review of the literature. Infect Disord Drug Targets. 2019; 19(2): 101 104.
| Files | ||
| Issue | Vol 20 No 4 (2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| Hydatid cyst Anaphylactic shock Perforation | ||
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How to Cite
1.
Feiz Disfani H, Panahi M. Anaphylactic Shock Following Spontaneous Rupture of Pulmonary Hydatid Cyst: A Case Report. Iran J Parasitol. 2025;20(4):596-601.
