Cystic echinococcosis (CE) is among the most common zoonotic infectionsworldwide. Studies about CE are limited in childhood. The aim of thisstudy was to evaluate clinical, radiological and laboratory characteristics ofchildhood CE at a tertiary care pediatric hospital. Medical records of childrenwith 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-13.2years) 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 patientswith liver cysts and lung cysts, respectively. The indirect hemagglutination(IHA) test positivity was 58%. Elevated serum total immunoglobulin E levelswere detected in 59% of the patients. Fourty-four patients with liver CE, 33patients with lung CE were treated surgically and 23 patients with liver CEwere treated with percutaneous aspiration, injection and re-aspiration (PAIR)along with medical treatment. The recurrence was observed in five patientswith liver CE.It was demonstrated that CE mainly involves liver but lung cysts are morefrequently symptomatic and prone to be complicated than liver cysts inchildren. IHA test positivity together with abdominal ultrasonography areuseful to diagnose liver CE but thorax CT is usually needed to diagnose lungCE. Liver cysts that are sized greater than 5 cm are more frequently treatedwith PAIR or surgery but smaller liver cysts can be treated medically.
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1. Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis 2009; 13: 125-133.
2. Moro PL, Schantz PM. Echinococcus Species (Agents of Cystic, Alveolar, and Polycystic Echinococcosis). In: Long SS, Pickering LK, Prober CG (eds). Principles and Practice of Pediatric Infectious Diseases (4th ed). Philedephia: Elsevier, 2012: 1356-1362.
3. WHO Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 2003; 85: 253- 261.
4. Djuricic SM, Grebeldinger S, Kafka DI, Djan I, Vukadin M, Vasiljevic ZV. Cystic echinococcosis in children - the seventeen-year experience of two large medical centers in Serbia. Parasitol Int 2010; 59: 257- 261.
5. Snábel V, Altintas N, D'Amelio S, et al. Cystic echinococcosis in Turkey: genetic variability and first record of the pig strain (G7) in the country. Parasitol Res 2009; 105: 145-154.
6. Yazar S, Yaman O, Cetinkaya F, Sahin I. Cystic echinococcosis in Central Anatolia, Turkey. Saudi Med J 2006; 27: 205-209.
7. Akalin S, Kutlu SS, Caylak SD, Onal O, Kaya S, Bozkurt AI. Seroprevalence of human cystic echinococcosis and risk factors in animal breeders in rural communities in Denizli, Turkey. J Infect Dev Ctries 2014; 8: 1188-1194.
8. Ok UZ, Ozkol M, Kilimcioğlu AA, et al. A provincebased study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, Turkey. Acta Trop 2007; 103: 116-122.
9. Pakala T, Molina M, Wu GY. Hepatic echinococcal cysts: A review. J Clin Transl Hepatol 2016; 4: 39-46.
10. Calma CL, Neghina AM, Vlaicu B, Neghina R. Cystic echinococcosis in the human population of a western Romanian county, 2004-2010. Clin Microbiol Infect 2011; 17: 1731-1734.
11. Tenguria RK, Naik MI. Evaluation of human cystic echinococcosis before and after surgery and chemotherapy by demonstration of antibodies in serum. Ann Parasitol 2014; 60: 297-303.
12. Jordanova DP, Harizanov RN, Kaftandjiev IT, Rainova IG, Kantardjiev TV. Cystic echinococcosis in Bulgaria 1996-2013, with emphasis on childhood infections. Eur J Clin Microbiol Infect Dis 2015; 34: 1423-1428.
13. Çevik M, Eser I, Boleken ME. Characteristics and outcomes of liver and lung hydatid disease in children. Trop Doct 2013; 43: 93-95.
14. Bartels C, Beaute J, Fraser G, et al; European Centre for Disease Prevention and Control (ECDC) Annual epidemiological report 2014: food- and waterborne diseases and zoonoses. Stockholm: ECDC; 2014.
15. Schantz PM. Progress in diagnosis, treatment and elimination of echinococcosis and cysticercosis. Parasitol Int 2006; 55(Suppl): S7-S13.
16. Dopchiz MC, Elissondo MC, Andresiuk MV, et al. Pediatric hydatidosis in the south-east of the Buenos Aires province, Argentina. Rev Argent Microbiol 2009; 41: 105-111.
17. Agudelo Higuita NI, Brunetti E, McCloskey C. Cystic echinococcosis. J Clin Microbiol 2016; 54: 518-523.
18. Torgerson PR, Deplazes P. Echinococcosis: diagnosis and diagnostic interpretation in population studies. Trends Parasitol 2009; 25: 164-170.
19. Wuestenberg J, Gruener B, Oeztuerk S, et al. Diagnostics in cystic echinococcosis: serology versus ultrasonography. Turk J Gastroenterol 2014; 25: 398- 404.
20. Tamarozzi F, Vuitton L, Brunetti E, Vuitton DA, Koch S. Non-surgical and non-chemical attempts to treat echinococcosis: do they work? Parasite 2014; 21: 75.
21. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114: 1-16.