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.

Vuitton DA: Echinococcosis and allergy. Clin Rev Allergy Immunol 2004;26:93–104.
Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis. Bull World Health Organ 1996;74:231–242.
Bakir I, Enc Y, Cicek S: Hydatid cyst in the pulmonary artery: an uncommon localization. Heart Surg Forum 2004;7:13–15.
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.
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.
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.
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.
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.
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.
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.
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.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.