A 32-year-old butcher presents with cystic lesions in the liver found on ultrasound. Serological tests (ELISA, IHA) are positive for Echinococcus. CT scan shows daughter cysts and a 'water lily sign'. The most dangerous complication of percutaneous drainage of this cyst is:

• A Secondary bacterial infection of the cyst
• B Seeding of daughter cysts within the peritoneum
• C Rupture into the biliary tree causing sclerosing cholangitis
• D Anaphylaxis due to spillage of cyst fluid containing scolices and antigenic material ✓

Explanation

Hydatid cyst (Echinococcus granulosus) fluid contains protoscolices, hydatid sand, and highly antigenic proteins that, when spilled during rupture or drainage, can trigger life-threatening anaphylactic shock. Secondary peritoneal seeding (implantation of scolices) is also a serious complication, but anaphylaxis is the most immediately dangerous. PAIR (Puncture-Aspiration-Injection-Re-aspiration) is now an accepted procedure when performed with albendazole cover and anaphylaxis preparedness.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.