Cystic echinococcosis in a child infected with HIV

Echinococcosis is a parasitic disease caused by the tapeworm Echinococcus granulosus. Echinococcus infection is possible at any age, including childhood. Most of the cases are recognized accidentally. HIV infection in children is rarely diagnosed in Poland. A currently 16-year-old girl was diagnosed with HIV vertical infection at the age of 13. Antiretroviral therapy was started after 6 months of observation. Routine ultrasound examination of her abdomen revealed a cystic lesion in the liver. The IgG ELISA test for E. granulosus infection was negative. However, she was treated with albendazole due to clinical suspicion of echinococcosis. After anti-parasitic treatment, an abdominal ultrasonography (US) and computed tomography (CT) scans were performed and revealed progression of the lesion (one year of observation). As an additional imaging study, biliary tract scintigraphy was done. Localization of the cyst allowed its surgical removal. The surgery was performed under pharmacological protection with albendazole. Histopathology examination confirmed the diagnosis of echinococcosis.Currently, the clinical condition of the patient is good, antiretroviral treatment is effective and repeated abdominal ultrasound is unremarkable. E. granulosus infection in children is rare and may be accompanied by other diseases and infections. Diagnosis is difficult and it is often based on the clinical picture without serological confirmation. Surgical treatment should be supplemented with pharmacological treatment.