Death following a series of anaphylactic crises in a case of multiple pulmonary hydatidosis treated with mebendazole

ABSTRACT

A young girls presented as a case of mediastinal and sub-cutaneous emphysema. Records showed that she had had 2 previous thoracotomies and a lower lobectomy to remove multiple hydatid cysts. X-rays showed cystic shadows along the right base of mediastinum and the right cardiophrenic angle. She had repeated attacks of anaphylaxis and each time responded to hydrocortisone, aminophylline, and antihistaminics. During one of her stable periods, she was started on mebendazole in 3 divided daily doses of 600, 900 and 1200 mg for the first 3 successive days, and thereafter on 1200 mg daily. She continued to have recurrent anaphylaxis which was attributed to her sensitization to hydatid fluid antigen from a slow leaking hydatid cyst [S]. Her IgE levels, CFT and IHA titres were depressed. Thirty days after the start of mebendazole treatment, she had the final attack of acute respiratory distress with restlessness and sweating. Despite the use of hydrocortisone and aminophylline, she went into an anaphylactic shock and all efforts to resuscitate her failed