The Turkish Journal of Pediatrics 2019 , Vol 61 , Num 5
Characteristics, diagnosis, and treatment modality of pediatric patients with cystic echinococcosis: a single centre experience
Ayşe Kaman 1 ,Gönül Tanır 1 ,Emin Çakmakçı 2 ,Pervin Demir 3 ,Fatma Nur Öz 1 ,Türkan Aydın Teke 1 ,Özge Metin 1 ,Zeynep Gökçe Gayretli Aydın 1 ,Ayşe Karaman 4
1 Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital
2 Departments of Radiology, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital
3 Department of Biostatistics, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
4 Departments of Pediatric Surgery, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital
DOI : 10.24953/turkjped.2019.05.009 Kaman A, Tanır G, Çakmakçı E, Demir P, Öz FN, Aydın Teke T, Metin Ö, Gayretli Aydın ZG, Karaman A. Characteristics, diagnosis, and treatment modality of pediatric patients with cystic echinococcosis: a single centre experience. Turk J Pediatr 2019; 61: 704-713.

Cystic echinococcosis (CE) is among the most common zoonotic infections worldwide. Studies about CE are limited in childhood. The aim of this study was to evaluate clinical, radiological and laboratory characteristics of childhood CE at a tertiary care pediatric hospital. Medical records of children with 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-13.2 years) 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 patients with liver cysts and lung cysts, respectively. The indirect hemagglutination (IHA) test positivity was 58%. Elevated serum total immunoglobulin E levels were detected in 59% of the patients. Fourty-four patients with liver CE, 33 patients with lung CE were treated surgically and 23 patients with liver CE were treated with percutaneous aspiration, injection and re-aspiration (PAIR) along with medical treatment. The recurrence was observed in five patients with liver CE.

It was demonstrated that CE mainly involves liver but lung cysts are more frequently symptomatic and prone to be complicated than liver cysts in children. IHA test positivity together with abdominal ultrasonography are useful to diagnose liver CE but thorax CT is usually needed to diagnose lung CE. Liver cysts that are sized greater than 5 cm are more frequently treated with PAIR or surgery but smaller liver cysts can be treated medically. Keywords : cystic echinococcosis, children, diagnosis, PAIR, treatment

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