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Cystic Echinococcosis in Pediatric Patients in Sivas Province: Clinical, Laboratory, Surgical, and Radiological
Kübra Fırtına Topcu1, Levent Cankorkmaz2, Mürşit Hasbek1
1Sivas Cumhuriyet University Faculty of Medicine, Department of Medical Microbiology, Sivas, Türkiye.
Objective:
This study aimed to retrospectively evaluate the serological, clinical, and radiological findings in the diagnosis of cystic echinococcosis (CE) in pediatric patients. The relationship between serological test results and clinical and radiological findings was also investigated.
Methods:
The study included 216 pediatric patients (under 18 years old) who underwent indirect hemagglutination assay (IHA) testing for CE differential diagnosis between January 2016 and December 2023. Demographic data, clinical symptoms, radiological imaging results, and surgical status were obtained from the hospital information management system. IHA tests were performed using a commercial kit (Hydatidose, Fumouze Laboratoires, France) following the manufacturer's protocol. A titer of ≥1/320 was considered positive, 1/160 as borderline, and <1/160 as negative. Statistical analysis was performed using SPSS 23.0, and a p-value <0.05 was considered significant.
Results:
CE was diagnosed in 40 (18.5%) of 216 patients based on combined clinical, laboratory, and radiological evaluations. The mean age of the patients was 11.92±4.14 years, and 52.5% were male. IHA test results were positive in 31 (77.5%) patients and negative in 9 (22.5%). Radiological imaging showed a single cyst in 67.5% of patients and multicystic appearance in 32.5%. The most common cyst localizations were liver (67.5%), lung (22.5%), spleen (7.5%), and brain (2.5%). Surgery was performed in 42.5% of patients, while 22.5% were followed non-surgically. No statistically significant relationship was found between cyst number, localization, and IHA positivity (p>0.05).
Conclusion:
The findings emphasize the importance of evaluating clinical, laboratory, and radiological data together for accurate and early diagnosis of CE. Due to the variable sensitivity of the IHA test, negative results should be confirmed with additional diagnostic methods. While radiological imaging provides critical information about cyst localization, further studies are needed to investigate the correlation between cyst number, localization, and clinical course. Larger patient series would help improve the diagnostic process and clinical management of pediatric CE.
