Overview of Hydatid Disease in Iranian Children

Abstract

Background: Hydatid disease (HD) is still an important health hazard in the world. This disease is a parasitic infestation endemic in many sheep-and cattle-raising areas such as Iran. Objectives: This study aimed to review the clinical manifestations, laboratory aspects, imaging findings, and management of HD. Patients and Methods: Data were collected from the medical records of patients diagnosed with HD in eight referral hospitals in different provinces of Iran from 2001 to 2014. Results: Overall, 161 children at a mean age of 9.25 ± 3.37 years (age range = 1 -15 years old) hospitalized with a definite diagnosis of the hydatid cyst between 2001 and 2014 were studied. The male-to-female ratio was 1.6:1. The most commonly involved organ was the lung (67.1%), followed by the liver (44.1%) and a combined liver and lung involvement was found in 15.5% of the patients. The cysts were found more frequently in the right lobe of the liver and lung than in the left lobe. The most frequent complaints were fever (35.4%) and abdominal pain (31.7%), and the most frequent sign was an abdominal mass in the liver involvement and cough in the lung involvement. There was a high eosinophil count (> 500/micL) in 41% of our cases. A high erythrocyte sedimentation rate (> 30) or positive C-reactive protein (based on the qualitative method) was found in 18.6% of the patients and leukocytosis > 15000/micL in 29.2% of the children. Ultrasonography was the main imaging test, with an accuracy rate of 96%, and chest X-ray was helpful in 88.6% of the cases. Surgery was performed in 89% of the patients, and selective patients underwent percutaneous aspiration-injection-reaspiration drainage or medical treatment. Conclusions: The lung was the most commonly involved organ in the children recruited in the present study. Given the high probability of multiple organ involvement, we recommend that patients with HD be assessed via ultrasonography and chest X-ray. In endemic regions, unexplained eosinophilia should be considered as a parasitic disease like HD and its complications.

The pattern of cystic echinococcosis in children in an endemic area in Morocco

“…Boys, more so than girls, are considered to be closer canine companions and may be more at risk to potential zoonotic infection through the faecal-oral route during the course of feeding, working or playing with their dogs. The results of this study corroborate those previously reported in other paediatric studies quoting that boys are more likely to be infected than girls, with male to female ratios ranging from 1.3:1 to 2.1:1 (Wang et al 2001;Durakbasa et al 2006;Fahimzad et al 2015). In contrast, a predominance of CE in females has been reported (Pierangeli et al 2007;Sanaei Dashti et al 2017).…”

Pulmonary Echinococcus in children: A descriptive study in a LMIC

“…This study indicates that the lung is the most common site of CE in children , similar to other pediatric data [4,5] . Pulmonary cysts grow slowly and are often asymptomatic until complications such as mass effect, rupture or secondary infection, occur [21] .…”

“…Unlike adults, where hepatic involvement is common, pulmonary CE is the dominant site in the pediatric population [4] . Pulmonary cyst/s are typically first seen on chest x-ray (CXR), either as an incidental finding or following respiratory symptoms after cyst rupture or secondary infection of the cyst [5] . Pulmonary cysts have a broad differential diagnosis in children and a definitive diagnosis relies on the combination of imaging, serology, and histology.…”

“…4 Pulmonary cyst/s are typically first seen on chest X-ray (CXR), either as an incidental finding or following respiratory symptoms after cyst rupture or secondary infection of the cyst. 5 Pulmonary cysts have a broad differential diagnosis in children and a definitive diagnosis relies on the combination of imaging, serology, and histology. In countries with high infectious burdens from diseases such as Human Immune Deficiency Virus (HIV) and tuberculosis (TB), 2,3 the diagnosis is additionally challenging, as atypical infections are more common than in developed countries.…”

Renal Hydatid Cyst or a Simple Cyst? Report of a Rare Case

“…Kidney-sparing surgery and cystectomy plus pericystectomy are feasible in 75% of cases and total nephrectomy must be performed for nonfunctional kidneys (2,5,8,12,13).…”