ABSTRACT
Anaphylactic shock due to unruptured hydatid cyst is a rare complication of hepatic echinococcosis. Here, we present an unusual case of unruptured hydatid cyst causing anaphylactic shock followed by appendicitis, ileus, and complicated by septic condition due to multiple intrahospital infections. Decision of the surgical cyst removal at the right moment and appropriate antimicrobial treatment are key factors for a positive outcome.
Subject(s)
Anaphylaxis/etiology , Appendicitis/complications , Cross Infection/complications , Echinococcosis, Hepatic/complications , Ileus/complications , Acute Disease , Echinococcosis, Hepatic/drug therapy , Echinococcosis, Hepatic/surgery , Enterocolitis, Pseudomembranous/complications , Humans , Ileus/surgery , Male , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Middle Aged , Pseudomonas Infections/complications , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/isolation & purification , Sepsis/complications , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
BACKGROUND AND OBJECTIVES: Published data on oxidative stress in children with acute hepatitis A are still very scarce. This study aims to evaluate the oxidant/antioxidant status of these patients. DESIGN AND SETTING: Prospective, case-control study, over 2.5 years in patients under hospitalized and ambulatory care. PATIENTS AND METHODS: The levels of a whole-blood antioxidant, reduced glutathione; and plasma antioxidants, ß-carotene, retinol, ascorbic acid, α-tocopherol; and the biomarker of oxidative stress, malondialdehyde, were evaluated in 50 pediatric patients (age range, 5-16 years; 29 males and 21 females) with acute hepatitis A and in 50 healthy children as control subjects (age range, 5-16 years; 25 males and 25 females). RESULTS: Plasma levels of reduced glutathione, ß-carotene, retinol, α-tocopherol and ascorbic acid were significantly lower, while malondialdehyde plasma levels were significantly increased in the patient group when compared to the controls (P<.0001 for all parameters). CONCLUSIONS: Our findings show that pediatric patients with acute hepatitis A were influenced by oxidative stress, resulting in significantly lower levels of plasma antioxidants and increased lipid peroxidation. In the absence of other therapeutic options, antioxidant vitamin supplements could be added to the therapy for these patients to help reestablish the oxidant status balance. Further investigations to confirm this suggestion are recommended.
