We describe the case of a 15-month-old boy with Kawasaki disease who developed varicella 7 days after the beginning of the disease and diffuse plaque psoriasis after 43 days. Associations between Kawasaki disease and psoriasis, between Kawasaki disease and varicella and between varicella and psoriasis have all been reported in the literature. The triple association of Kawasaki disease, varicella and psoriasis is very rare. Neither the double nor the triple associations are well known among a diverse group of practitioners.
Background: Hydatid disease in humans is caused by the taeniid Echinococcus. It usually presents as an
asymptomatic hepatic cyst. Its manifestation as anaphylactic shock is exceptional.
Aim: To present a clinical case of anaphylaxis due to hydatidosis.
Material and Methods: A 32-year-old farmer man was admitted as emergency with pruritus in the hands,
feet and armpits associated with erythema, facial edema and generalized habonasal lesions. He referred
feeling of respiratory distress. The examination revealed a hypotensive and tachycardia patient, with a
baseline oxygen saturation of 90%. Blood analysis revealed leukocytosis stands, without other notable
findings as a normal liver profile. During hospital care, he presented a single episode of fever of 38ºC
without focality. After 48 hours of close monitoring, the patient remains asymptomatic, so discharge home
is decided.
Results: The study by allergology showed eosinophilia, high levels of IgE with low C4 and positive
serology for E. granulosus stand out. A thoraco-abdominopelvic computed tomography showed a lesion of
a cystic nature in the right hepatic lobe, corresponding to a CE3 transitional hydatid cyst (WHO
classification). After treatment with Albendazol, a closed cystopericystectomy is performed using a right
subcostal laparotomy that proceeds without incident.
Conclusion: Despite the fact that anaphylaxis secondary to hydatid disease is rare, it should always be
included in the differential diagnosis of an episode of anaphylactic reaction of unknown cause due to the
severity of the disease and the specificity of the required treatment.
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