Multi‐organ/disseminated echinococcosis in children: Case series and review of the literature

Abstract

Aim: Echinococcosis with multi-organ/disseminated involvement is rare in childhood. We aimed to evaluate the clinical and laboratory characteristics and prognosis in paediatric patients with echinococcosis having multiorgan/disseminated involvement. Method: We evaluated retrospectively children with echinococcosis with involvement of three or more organs. Results: Thirteen patients were included in the study. The median age was 120 (range 71-189) months. Three (23%) were diagnosed incidentally. Abdominal pain was seen in 5 (38.4%) patients, vomiting in 4 (30.7%), headache in 3 (23%), cough in 2 (15.3%), groin pain in 1 (7.6%), 1 (7.6%) had jaundice and 1 (7.6%) had fever. The median duration of complaints was 48 (0-140) days. The most common tripartite organ was 38.4% (5/13) liver, lung and spleen. Isolated abdominal dissemination was detected in two patients. Two patients had multi-organ involvement and multiple cysts with dissemination. Cyst rupture was observed in three of the patients; recurrent urinary tract infection, hydroureteronephrosis, secondary peritonitis with intraabdominal abscess, and biliary tract fistula were each observed in one patient. Relapse developed in 3 (23%) patients. Conclusion: Echinococcosis is a very slow growing and complex parasitic disease that affects many organs and tissues. In our study, eosinophilia, recurrence, and complications were seen at a higher rate in paediatric patients with multiorgan involvement, who required repetitive surgeries and long-term medical treatment. However, there are scanty data on risk factors, optimum treatment and prognosis.

Çocuklarda Kistik Ekinokokkoz: On Yıllık Tecrübe ve Rüptüre Olguları Değerlendirmede Hangi Laboratuar Sonucu?

“…[13,21] In a study evaluating the cases with multiple organ involvement, it was reported that the liver, lung and spleen (38.5%) were affected most frequently. [22] In our study, the most involved areas were the right lobe of the liver (75%) and the left lung (58.3%). Cysts <50 mm in size are called small cysts and mm are "giant cysts".…”

Severe multilobar lung echinococcosis with multiorgan involvement in a child

“…Limited number of studies have reported renal involvement in pediatric cases. [1][2][3] In the study by Mfingwana 1 and colleagues, only two cases with lung involvement additionally had spleen involvement, while no case of renal involvement was observed. At the same time, In the study by Çay 2 and colleagues, only three cases with lung involvement additionally had renal involvement.…”

“…The renal involvement was especially significant in this case. Limited number of studies have reported renal involvement in pediatric cases 1–3 . In the study by Mfingwana 1 and colleagues, only two cases with lung involvement additionally had spleen involvement, while no case of renal involvement was observed.…”

“…We would like to share the 16‐year‐old adolescent case with very demonstrative postero‐anterior chest X‐ray and computed tomography images. The recent case series by Mfingwana 1 and Çay 2 are very beneficial to clinicians for interpretation of the topic. In these studies, the authors described 48 pediatric cases between ages 3–18 with different organ involvement.…”