Characteristics, diagnosis, and treatment modality of pediatric patients with cystic echinococcosis: a single centre experience

Özet

Cystic echinococcosis (CE) is among the most common zoonotic infectionsworldwide. Studies about CE are limited in childhood. The aim of thisstudy was to evaluate clinical, radiological and laboratory characteristics ofchildhood CE at a tertiary care pediatric hospital. Medical records of childrenwith CE were analyzed between January 2005 and January 2015.A total of 130 patients with a median age of 10.4 years (IQR= 7.2-years-13.2years) were evaluated. The anatomic locations of cysts were as follows; liver(76.9%), lung (36.9%), spleen (6.2%), pelvic region (3.8%) and kidney (2.3%).The most common symptoms were abdominal pain and cough in the patientswith liver cysts and lung cysts, respectively. The indirect hemagglutination(IHA) test positivity was 58%. Elevated serum total immunoglobulin E levelswere detected in 59% of the patients. Fourty-four patients with liver CE, 33patients with lung CE were treated surgically and 23 patients with liver CEwere treated with percutaneous aspiration, injection and re-aspiration (PAIR)along with medical treatment. The recurrence was observed in five patientswith liver CE.It was demonstrated that CE mainly involves liver but lung cysts are morefrequently symptomatic and prone to be complicated than liver cysts inchildren. IHA test positivity together with abdominal ultrasonography areuseful to diagnose liver CE but thorax CT is usually needed to diagnose lungCE. Liver cysts that are sized greater than 5 cm are more frequently treatedwith PAIR or surgery but smaller liver cysts can be treated medically.