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Updated: Sep 15, 2025
Transient Transduction of the Strobilated Forms of Echinococcus granulosus
Published on: September 16, 2022
Acute peritoneal propagation of alveolar echinococcosis in a 12-year-old child
Kinga Karolina Kardics1, Krisztina Kalocsai1, Attila Kálmán1
11Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest, Hungary.
Insights
This case study highlights a rare pediatric alveolar echinococcosis (AE) diagnosis in Hungary. Early detection and multidisciplinary management are crucial for this parasitic liver disease.
Area of Science:
- Parasitology
- Pediatric Medicine
- Radiology
Background:
- Pyogenic liver abscess is a common pediatric diagnosis, but treatment failure warrants further investigation.
- Echinococcosis, a parasitic infection, presents diagnostic challenges, especially in pediatric cases.
- Alveolar echinococcosis (AE) is a rare but serious form of Echinococcus infection.
Purpose of the Study:
- To report the first pediatric case of alveolar echinococcosis (AE) in Hungary.
- To emphasize the diagnostic challenges in differentiating AE from other liver pathologies in children.
- To highlight the importance of multidisciplinary management for pediatric AE.
Main Methods:
- Case presentation of a 12-year-old child with acute symptoms.
- Utilized ultrasound and MRI for lesion detection, alongside serological investigations for Echinococcus granulosus.
- Included antihelminthic therapy, surgical intervention, and continuous albendazole administration.
- Histopathological and parasitological analysis for definitive diagnosis.
Main Results:
- Initial presentation mimicked pyogenic liver abscess, unresponsive to antibiotics.
- Rising eosinophilia and multiplex focal lesions prompted further investigation.
- Confirmed diagnosis of alveolar echinococcosis (AE) caused by Echinococcus multilocularis.
- Successful management involved surgery and prolonged albendazole therapy.
Conclusions:
- Pediatric AE is rare and can be misdiagnosed due to its slow progression and varied presentation.
- Differential diagnosis between cystic and alveolar echinococcosis is critical in endemic areas.
- Multidisciplinary approach and timely intervention are essential for favorable outcomes in pediatric AE.
Abstract:
Herein we present a case of a 12-year-old child with acute symptoms (abdominal pain, fever). Preliminary imaging suggested pyogenic liver abscess. Despite the broad-spectrum antibiotic therapy, which was started after hospital admission, no improvement was perceived. Rising eosinophilia and multiplex focal lesions detected by ultrasound and MRI forced serological investigation by which Echinococcus granulosus s.l. seropositivity was detected. Antihelminthic therapy was initiated and upon multidisciplinary consultation surgical intervention was performed with the removal of a cystic lesion which ruptured to the peritoneal cavity. Histopathological and parasitological analysis finally verified alveolar echinococcosis (AE) caused by Echinococcus multilocularis. As the evacuation of one lesion cannot be regarded as curative intervention in this form of echinococcosis, albendazole was administered continuously until patient's medical condition improved and no progression was detected during imaging follow-up. In Hungary both cystic and alveolar echinococcosis are present therefore differential diagnosis of these two forms can be a clinical challenge. Slow rate of progression, long lasting asymptomatic period and relatively low incidence of AE disease can explain that cases during childhood are rarely identified. After reviewing all relevant literature in this topic, we present here the first pediatric AE case in Hungary.
