Hydatid Disease in Children from Diagnosis to Treatment: A 10-year Single Center Experience

Abstract

Hydatid disease caused by Echinococcus granulosus is a parasitic zoonosis and is endemic in Turkey. Clinical manifestations vary and are related to the anatomical location. In this report, we shared the diagnosis, treatment and follow-up of hydatid disease in children with a 10-year experience. A total of fifty-seven children diagnosed with hydatid disease were analyzed retrospectively from hospital records. Diagnosis was based on clinical, serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings. The male/female ratio of 57 cases was 2.4:1 and the mean age was 113.6±45.9 months. The most common presenting complaint was abdominal pain (42.1%). While 22 (38.6%) of the cases had eosinophilia; indirect hemagglutination test positivity was detected in 27 cases (47.4%). Multiple organ involvement was present in 18 cases (31.6%). In patients with multiple organ involvement, the possibility of cysts being located in the abdomen was higher (p=0.005). Of the 50 cases (87.7%), 45 (78.9%) were operated with open surgery and 5 (8.8%) with percutaneous aspiration-injection-reaspiration method for treatment. There were 52 (91.2%) patients who were given albendazole in conservative treatment and the mean duration of treatment was 15.5±17.2 months. There were 10 cases (17.5%) who developed cyst rupture and the symptom duration was shorter than the cases without cyst rupture (p=0.017). Cyst rupture was more common in cases with dyspnea and fluid discharge from the mouth called rock water (p=0.001, p=0.005, respectively). Recurrence was observed in five cases (8.8%) during follow-up. In areas where the disease is endemic, despite prevention and control programs consisting of personal habits and health education, active transmission of hydatid disease is seen in children and continues to be an important public health problem. Hydatid disease should definitely be considered in the presence of suspicious radiological and clinical findings in endemic areas. Controlled clinical studies are required for diagnosis and treatment procedures.