Friebe Mathias, Große Düweler Christina, Theurer Sarah
Zentrale Notaufnahme, Evangelisches Krankenhaus Oberhausen.
Institut für Pathologie, Universitätsklinikum Essen.
Dtsch Med Wochenschr. 2020 Sep;145(18):1321-1324. doi: 10.1055/a-1145-0454. Epub 2020 Sep 9.
We report the case of a 27-year-old Syrian patient who came to the emergency department with a syncopal episode. No medical history could be raised due to a language barrier and so the clinical presentation was leading.
The patient exhibited signs of shock, accompanied by an exanthema as well as perioral hematin. In an ultrasound sonography free intraabdominal fluid and an obscure change in the upper abdomen could be visualized. An esophagogastroduodenoscopy showed evidence of an ulcer, however did not explain all symptoms. In a CT abdomen, signs of a ruptured cyst could be demonstrated.
The patient stabilized under the treatment protocol for anaphylaxis. Due to the clinical course and country of origin the patient received albendazole and a partial liver resection for a suspected echinococcus cyst.
Obscure clinical symptoms alongside signs of shock, should always considered to be an allergic reaction in absence of sepsis or hemorrhage. In anaphylaxis, echinococcosis should always be included in the differential diagnosis.
我们报告一例27岁叙利亚患者，该患者因晕厥发作前来急诊科就诊。由于语言障碍，无法获取病史，因此以临床表现为主。
患者表现出休克体征，伴有皮疹和口周瘀斑。超声检查可见腹腔内有游离液体，上腹部有模糊变化。食管胃十二指肠镜检查显示有溃疡迹象，但无法解释所有症状。腹部CT显示有囊肿破裂的迹象。
患者在过敏性反应治疗方案下病情稳定。鉴于临床病程和患者原籍国，患者接受了阿苯达唑治疗，并因疑似棘球蚴囊肿接受了部分肝切除术。
在没有败血症或出血的情况下，伴有休克体征的不明原因临床症状应始终考虑为过敏反应。在过敏性反应中，棘球蚴病应始终列入鉴别诊断。
