Advertisement

Wiener klinische Wochenschrift

, Volume 127, Issue 3–4, pp 151–159 | Cite as

Clinical–Pathological Conference Series from the Medical University of Graz

Case No. 151: 19-year-old student from Albania with emergency admission due to shock
  • Elisabeth Fabian
  • Christian Madl
  • Sabine Horn
  • Peter Kornprat
  • Ralph Maderthaner
  • Ariane Aigelsreiter
  • Robert Krause
  • Peter Fickert
  • Guenter J. KrejsEmail author
Clinical-Pathological Conference

Presentation of case

Dr. S. Horn

On the day of admission, the previously healthy 19-year-old student from Albania felt sick and vomited three times. She experienced a hot flash, flickering in the visual field, and a macular rash on her abdomen, followed by loss of consciousness. The emergency physician gave her a Glasgow Coma Score (GCS) of 3. On route to the hospital, she became hypotensive. When the electrocardiography showed tachycardic supraventricular arrhythmia and fibrillation, cardioversion was performed. She was then hemodynamically stable on admission to the intensive care unit but subsequently developed fever and laboratory evidence of inflammation. Intravenous antibiotic therapy (ampicillin and sulbactam) was begun. A drug screen of her urine was positive for methamphetamine, but she later denied any drug abuse and could not imagine how she could have tested positive for the drug. Selected laboratory results: day of admission: leukocytes 17.8 G/l (normal 4.4 -11.3); 70 %...

Keywords

Hydatid cyst rupture Echinococcus granulosus anaphylactic shock 

Notes

Acknowledgements

The authors express their sincere gratitude to Eugenia Lamont for language editing of the manuscript.

Conflict of interest

All authors declare that there is no conflict of interest.

References

  1. 1.
    Kelly KL. Ranitidine cross-reactivity in the EMIT d.a.u. monoclonal amphetamine/methamphetamine assay. Clin Chem. 1990;36:1391–2.PubMedGoogle Scholar
  2. 2.
    Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010;67:1344–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Winek CL, Elzein EO, Wahba WW, Feldman JA. Interference of herbal drinks with urinalysis for drugs of abuse. J Anal Toxicol. 1993;17:246–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Eckert J, Schantz P, Gasser R, et al. Geographic distribution and prevalence. In: Eckert J, Gemmell MA, Meslin F-X, Pawlowski ZS, editors. WHOI/OIE manual on echinococcosis in humans and animals: a public health problem of global concern. Paris: World Organisation for Animal Health; 2001. pp. 100–41.Google Scholar
  5. 5.
    Moro P, Schantz PM. Echinococcoisis: a review. Int J Infect Dis. 2009;13:125–33.CrossRefPubMedGoogle Scholar
  6. 6.
    Anand S, Rajagopalan S, Mohan R. Management of liver hydatid cysts—current perspectives. Med J Armed Forces India. 2012;68:304–9.CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Köppen S, Wejda B, Dormann A, Seesko H, Huchzermeyer H, Junghanss T. Anaphylactic shock caused by rupture of an echinococcal cyst in a 25-year-old asylum seeker from Georgia. Dtsch Med Wochenschr. 2003;128:663–6.CrossRefPubMedGoogle Scholar
  8. 8.
    De Diego Choliz J, Lecumberri Olaverri FJ, Franquet Casas T, Ostiz Zubieta S. Computed tomography in hepatic echinococcosis. AJR Am J Roentgenol. 1982;139:699–702.CrossRefPubMedGoogle Scholar
  9. 9.
    Atmatzidis KS, Pavlidis TE, Papaziogas BT, Mirelis C, Papaziogas TB. Recurrence and long-term outcome after open cystectomy with omentoplasty for hepatic hydatid disease in an endemic area. Acta Chir Belg. 2005;105:198–202.PubMedGoogle Scholar
  10. 10.
    Junghanss T, Menezes da Silva A, Horton J, Chiodini PL, Brunetti E. Clinical management of cystic echinococcosis: state of the art, problems and perspectives. Am J Trop Med Hyg. 2008;79:301–11.PubMedGoogle Scholar
  11. 11.
    McManus DP, Zhang W, Li J, Bartley PB. Echinococcosis. Lancet. 2003;362:1295–304.CrossRefPubMedGoogle Scholar
  12. 12.
    Daradkeh S, El-Muhtaseb H, Farah G, Sroujieh AS, Abu-Khalaf M. Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver. Langenbecks Arch Surg. 2007;392:35–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Demirci S, Eraslan S, Anadol E, Bozatli L. Comparison of the results of different surgical techniques in the management of hydatid cysts of the liver. World J Surg. 1989;13:88–90.CrossRefPubMedGoogle Scholar
  14. 14.
    Taylor BR, Langer B. Current surgical management of hepatic cyst disease. Adv Surg. 1997;31:127–48.PubMedGoogle Scholar
  15. 15.
    Daradkeh S, El-Muhtaseb H, Farah G, Sroujieh AS, Abu-Khalaf M. Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver. Langenbecks Arch Surg. 2007;392:35–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Ammann RW, Eckert J. Cestodes: Echinococcus. Gastroenterol Clin N Am. 1996;25:655–89.CrossRefGoogle Scholar
  17. 17.
  18. 18.
    Nothdurft HD, Jelinek T, Mai A, Sigl B, von Sonnenburg F, Löscher T. Epidemiologie der Echinokokkose in Bayern. Dtsch Med Wochenschr. 1995;120:1151–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Report on Zoonosis in Austria, AGES 2011. http://www.ages.at/uploads/media/Zoonosenbericht-2011_ebook_03.pdf. Accessed 15 March 2014.
  20. 20.
    Center for Disease Control and Prevention. http://www.dpd.cdc.gov/dpdx/echinococcosis/index.html.. Accessed 19 March 2014
  21. 21.
    Frider B, Larrieu E, Odriozola M. Long-term outcome of asymptomatic liver hydatidosis. J Hepatol. 1999;30:228–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Mueller PR, Dawson SL, Ferrucci JT, Jr., Nardi GL. Hepatic echinococcal cyst: succsessful percutaneous drainage. Radiology. 1985;155:627–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Khuroo MS, Dar MY, Yattoo GN, Zargar SA, Javaid G, Khan BA, Boda MI. Percutaneous drainage versus albendazole therapy in hepatic hydatidosis: a perspective, randomized study. Gastroenterology. 1993;104:1452–59.PubMedGoogle Scholar
  24. 24.
    World Health Organization, Informal Working Group (IFWG). International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop. 2003;85:253–61.CrossRefGoogle Scholar
  25. 25.
    Brunetti E, Kern P, Vuitton DA, Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114:1.CrossRefPubMedGoogle Scholar
  26. 26.
    Malik AA, Bari SUL, Amin R, Jan M. Surgical management of complicated hydatid cysts of the liver. World J Gastrointest Surg. 2010;2:78–84.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Weller PF, Moskowitz G. Case records of the Massachusetts General Hospital: case 45-1987. N Engl J Med. 1987;317:1209–18.CrossRefGoogle Scholar
  28. 28.
    Bristow BN, Lee S, Shafir S, Sorvillo F. Human echinococcosis mortality in the United States, 1990–2007. PloS Negl Trop Dis. 2012:6(2):e1524.Google Scholar
  29. 29.
    Islam S, Schucany WG, Hurst DC, Lepe-Suastegui MR. Echinococcus granulosus infection presenting as right upper-quadrant abdominal pain. Proc (Bayl Univ Med Cent). 2012;25:80–82.Google Scholar

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Elisabeth Fabian
    • 1
  • Christian Madl
    • 2
  • Sabine Horn
    • 3
  • Peter Kornprat
    • 4
  • Ralph Maderthaner
    • 5
  • Ariane Aigelsreiter
    • 6
  • Robert Krause
    • 7
  • Peter Fickert
    • 1
    • 6
  • Guenter J. Krejs
    • 1
    Email author
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal MedicineMedical University of GrazGrazAustria
  2. 2.4th Department of Medicine with Subspecialities Gastroenterology, Hepatology and EndoscopyRudolfstiftung HospitalViennaAustria
  3. 3.Division of Nephrology, Department of Internal MedicineMedical University of GrazGrazAustria
  4. 4.Department of SurgeryMedical University of GrazGrazAustria
  5. 5.Division of General Diagnostic Radiology, Department of RadiologyMedical University of GrazGrazAustria
  6. 6.Department of PathologyMedical University of GrazGrazAustria
  7. 7.Section of Infectious Diseases and Tropical Medicine, Department of Internal MedicineMedical University of GrazGrazAustria

Personalised recommendations