Department of Tuberculosis and Chest Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Uttar Pradesh, India.
Respir Care. 2011 Jun;56(6):863-5. doi: 10.4187/respcare.00821. Epub 2011 Feb 11.
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.
肝包虫囊肿是一种由寄生虫带绦虫，细粒棘球绦虫引起的疾病，最常累及肝脏和肺部。破裂的肺包虫囊肿可能会带来诊断挑战，且 X 光片可能无法明确诊断。过敏性反应是破裂的肺包虫囊肿的罕见并发症。一名 22 岁男性因呼吸急促和意识改变而来我院急诊就诊，这些症状在前一天出现。X 光片显示右上肺野有一个薄壁环状半透明区域，被误诊为气胸，并插入了肋间胸腔引流管。5 天后，重复 X 光片显示有空腔和液气平面。胸腔引流管被移除，增强 CT 显示有空腔和睡莲征，提示破裂的包虫囊肿。细粒棘球蚴的免疫球蛋白-G 酶联免疫吸附试验呈阳性。该患者对晶体液输注、补充氧气和阿苯达唑治疗反应良好，然后接受了手术。由于包虫囊肿破裂引起的过敏性反应很少见，但在细粒棘球蚴流行地区的患者中应怀疑包虫病。
