Multiorgan involvement in a pediatric patient with hydatid disease

Lung Hydatidosis Unveiled: A Multisystem Mirage of Pathological Rarity

Lung hydatidosis is a zoonotic infection, primarily caused by Echinococcus sp., and has a significant role in the economy and public health. Canines are the predominant hosts of these parasitic tapeworms. Lungs are the most commonly infected organ after the liver. Hepatic pulmonary blood circulation is mainly reported to transport infection to the lungs. The prevalence of hydatid disease has increased over the past decade. In addition, patients with multi-organ involvement of hydatid cysts have been reported in different parts of the world. Hydatidosis can remain asymptomatic for years after infection in some conditions, especially in cases of splenic hydatidosis. Chest radiography and computed tomography findings can be used to confirm the diagnosis of hydatid disease. Hydatid disease is, in general, managed by pharmacological therapy, but if multi-organ involvement is observed, surgery along with medical management is required. Long-term follow-up is recommended in such cases to check the recurrence of the disease.

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

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 intra-abdominal 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.

Disseminated Hydatid Disease in a Child Involving Multiple Organ Systems: A Case Report

Hydatid disease is a parasitic infestation by Echinococcus granulosus, which involves the liver and lungs primarily. The authors report a case of disseminated hydatid disease involving multiple organs simultaneously in a 7-year-old child from Kabul, Afghanistan. The patient under examination had been having a complaint of cough and low-grade fever for the last one year. Computed tomography (CT) and ultrasonography (USG) demonstrated cystic lesions in his liver, lungs, spleen, and suprarenal region. The literature review showed that it was very rare for hydatid disease to involve multiple organs simultaneously, even in endemic areas, and the management of disseminated disease was very challenging, especially in the pediatric population.