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Ten-year follow-up of children with hydatid cysts
Tuğba Şişmanlar Eyüboğlu1, Tuğba Ramaslı Gürsoy2, Ayşe Tana Aslan2
1Department of Pediatric Chest Diseases, Dr. Sami Ulus Obstetrics, Gynecology and Children's Training and Research Hospital, Ankara, Turkey.
Insights
Hydatid cystic disease in children can affect various organs. Recurrence risk is higher for children with hydatid cysts in organs other than the lungs or liver, requiring careful monitoring.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Parasitology
Background:
- Hydatid cystic disease is an endemic parasitic infection with global prevalence.
- Echinococcosis poses a significant health challenge, particularly in endemic regions.
- Pediatric cases require specific consideration due to unique clinical presentations and management.
Purpose of the Study:
- To review demographic, clinical, and laboratory findings in pediatric hydatid cystic disease.
- To analyze treatment modalities and outcomes in affected children.
- To identify factors influencing treatment response and recurrence in pediatric hydatidosis.
Main Methods:
- Retrospective review of clinical records of pediatric patients (under 18) diagnosed with hydatid cyst disease.
- Data collection included demographics, exposure history, clinical symptoms, organ involvement, diagnostic tests, treatments, and follow-up outcomes.
- Analysis of factors associated with treatment response and recurrence.
Main Results:
- Fifty pediatric patients were analyzed over a 10-year period, with a mean age of 9.3 years; 66% were male.
- Lung and liver were the most common sites of involvement (36% and 25% respectively), with 28% having both.
- Relapse occurred in 7 patients, with significantly higher frequency in those with non-lung/liver organ involvement (p<0.05).
Conclusions:
- Hydatid cysts in children can manifest with diverse organ involvement.
- Patients with hydatidosis affecting organs beyond the lungs and liver necessitate vigilant follow-up due to increased recurrence rates.
- Early diagnosis and tailored treatment strategies are crucial for managing pediatric hydatid cystic disease.
Aim:
Hydatid cystic disease is an endemic parasitic disease that is common in the world. We aimed to review the demographic, clinical and laboratory findings, and treatments and outcomes of children with hydatid cyst disease, and to determine the factors affecting treatment response in two pediatric pulmonology centers in the central region of Turkey.
Material And Methods:
The clinical records of patients aged below 18 years who were followed up between January 2006 and December 2016 because of hydatid cyst disease were reviewed retrospectively. The patients' ages at the time of diagnosis, sexes, living areas (rural /urban), dog contact history, presence of hydatid cyst in other family members, symptoms, organs involved, dimensions of cysts, laboratory results, treatments and post treatment responses, follow-up, and outcomes were noted.
Results:
In a period of 10 years, 50 pediatric patients were followed up with a diagnosis of hydatid cyst. The mean age was 9.3±0.5 years and 33 (66%) of the patients were male. Fifteen patients were living in a rural area and 35 were living in an urban area. Fifteen patients had a history of contact with a dog and 10% had a positive family history. Thirty-six patients had lung involvement, 25 had liver involvement, 14 (28%) had both lung and liver involvement, and six patients had organ involvement other than lung and liver. The indirect hemagglutination test for hydatid cyst was positive in 24 of 40 patients and Echinococcus granulosus-specific IgE positivity was detected in 8 of 17 patients. Surgery was performed in 31 patients with lung involvement and PAIR was performed in 13 patients who had liver involvement. Cyst excision was performed in two patients who had isolated spinal involvement. All patients were treated with albendazole, and additional praziquantel treatment was given to seven patients. Relapse occurred in seven patients in this period. The relapse frequency was higher in patients who had organ involvement other than in the lung and liver (p<0.05), and these patients' treatment durations were longer compared with the others (p<0.05).
Conclusion:
Hydatid cysts can involve different organs in children. Patients with organ involvement other than the lung and liver should be followed up carefully in terms of recurrence.
