Medical Journal of The Islamic Republic of Iran (MJIRI)

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Hydatid cyst, the larval stage of Echinococcus spp., is a common parasitic disease in Iran. The liver and the lungs are the most commonly involved organs. Hydatid cysts have also been reported in bones and soft tissues such as muscle, brain tissue, spleen, thyroid and even in the heart. Hydatid cyst of the inguinal area, resembling a hernia is a rarity presenting at an unusual site. A hypersensitivity reaction to components of hydatid fluid may cause a serious or even fatal reaction if cyst rupture occurs. Sudden occurrence, lack of a good clinical history, and the severity and complexity of symptoms and signs makes the diagnosis difficult. This paper reports sudden rupture of an inguinal hydatid cyst in a patient while taking a bath, resulting in severe anaphylactic shock and acute pulmonary edema, wrongly described by the patient's family as "steam suffocation". This case report emphasizes the value of a good and detailed clinical history, the need to include hydatid cyst in the list of inguinal swellings in endemic areas, and to consider hydatid cyst rupture in the differential diagnosis of sudden shock, sudden LVF, pulmonary edema and severe allergic reactions.

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