Background: Hydatid disease, a parasitic infestation of humans, is endemic in the Mediterranean region, Australia, New Zealand and the Middle East, and mostly involves the liver. Anaphylactic reactions, which sometimes are the first manifestations of the disease, frequently occur due to cyst rupture after a minor/major trauma, though they may also be spontaneously seen on rare occasions. In extremely few studies, anaphylactic shock has been reported in patients without macroscopic rupture of the hydatid cysts. Case Report: Our patient had recurrent anaphylactic episodes without any trauma and had been misdiagnosed for several years even though the patient was living in a region endemic for hydatid disease. Conclusion: We emphasize that physicians should be highly aware of hydatid disease as a possible etiology for seemingly idiopathic anaphylactic reactions, especially in endemic regions.

1.
Vuitton DA: Echinococcosis and allergy. Clin Rev Allergy Immunol 2004;26:93–104.
2.
Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis. Bull World Health Organ 1996;74:231–242.
3.
Bakir I, Enc Y, Cicek S: Hydatid cyst in the pulmonary artery: an uncommon localization. Heart Surg Forum 2004;7:13–15.
4.
Mooraki A, Rahbar MH, Bastani B: Spontaneous systemic anaphylaxis as an unusual presentation of hydatid cyst: report of two cases. Am J Trop Med Hyg 1996;55:302–303.
5.
Georgiou S, Maroulis J, Monastirli A, et al: Anaphylactic shock as the only clinical manifestation of hepatic hydatid disease. Int J Dermatol 2005;44:233–235.
6.
Buyuk Y, Akcay Turan A, Uzun I, et al: Non-ruptured hydatid cyst can lead to death by spread of cyst content into bloodstream: an autopsy case. Eur J Gastroenterol Hepatol 2005;17:671–673.
7.
Wellhoener P, Weitz G, Bechstein W, et al: Severe anaphylactic shock in a patient with a cystic liver lesion. Intensive Care Med 2000;26:1578.
8.
Giulekas D, Papacosta D, Papaconstantinou C, et al: Recurrent anaphylactic shock as a manifestation of echinococcosis. Report of a case. Scand J Thorac Cardiovasc Surg 1986;20:175–177.
9.
Camunez F, Sinco G, Robledo R, et al: Ultrasound diagnosis of ruptured hydatid cysts of the liver with biliary obstruction. Gastrointest Radiol 1986;11:330–333.
10.
Larrieu E, Frider B, Del Caprio M, et al: Asymptomatic carriers of hydatidosis: epidemiology, diagnosis and treatment (in Spanish). Rev Panam Salud Publica 2000;8:250–257.
11.
Akyıldız EU, Yılmazer O, Suner C: Sudden death after blunt trauma: intravascular spread of the content of hydatid cyst and associated anaphylactic shock? J Forens Med Turkey 2003;17:1–3.
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