Anaphylactic Shock Diagnosed with Bedside Abdominal Ultrasonography and Computerized Tomography

Aim: The utility of ultrasound in assisting with the presentation of undifferentiated shock is becoming widely accepted as an invaluable tool with triaging both etiology and treatment. We believe this case highlights the utility of ultrasound in assisting with the clinical care of patients with anaphylactic shock. Case: Here, we present a 29-year-old man with no medical history, who was brought to our emergency department (ED) as intubated due to unconsciousness, hypotension, severe dyspnea and pruritus. On arrival to our ED, his pulse was filiform, and his extremities were cold and cyanotic. FAST examination to rule out trauma revealed anechoic cysts in liver. His abdominal CT revealed ruptured pouch of a hydatid cyst. He was admitted to ICU after 2-day follow up in the surgery clinics. He was discharged with full recovery. Conclusion: In conclusion, when critically ill patients with undifferentiated shock present in areas where animal husbandry is common, anaphylaxis due to hydatid cyst rupture should be kept in mind. Given the age, local agricultural practices, and presentation of distributive shock with concomitant liver cysts on ultrasonography we were able to triage the patient to abdominal computerized tomography scan and ultimately to definitive treatment.