[Clinical and parasitologic specifics of echinococcosis in children and teenagers: 68 cases].

UNLABELLED

Growth, fertilization and survival of the hydatid cyst (HC) in humans are elements of morpho-biology resulting from parasite-host interaction, being of major medical importance, especially in young subjects. Anti-parasitic chemotherapy with Albendazole (ALZ) proves to be of undeniable benefit, representing, additional to surgery, the modern conduct in echinococcosis.

AIM

Clinical and parasitological evaluation of the efficacy of ALZ on HC and emphasizing of the peculiarities of hydatidosis in children.

MATERIAL AND METHOD

Prospective and retrospective analysis of 68 cases of juvenile hydatidosis (4-16 years-old), divided in group A - with ALZ chemotherapy before surgery (14 cases) - and group B (with or without relapses) - with postsurgical chemotherapy alone (54 cases). Evaluation was performed macroscopically during surgery, parasitologically (viability of protoscolices) and histological.

RESULTS

The action of ALZ is incisive, degenerative-necrotic, on the HC wall (9 of 14 cases) and reduced upon the hydatid fluid and protoscolices. Primary echinococcosis in children is frequently multi-visceral (23 cases or 33.8%), and in the secondary forms, HC relapses mostly in other organs (7 cases or 10.2%) versus 3 cases or 4.4% "in situ" suggesting the circulation in Romania of highly- and multi-visceral invasive biotypes of E. granulosus. Thoracic organs are most frequently parasitised (48,5%), followed by the abdominal ones (41.1%), but unusual locations are common. Clinically, in children, HC has extreme outcome, with predominance of large HC, of more than 8 cm diameter (45.5%), and serious clinical features.

CONCLUSION

Echinococcosis in children and adolescents is frequently multi-organic, with severe clinical features and with HC of extreme size. ALZ effect on HC is obvious, incisive at cyst wall level. In pediatric hydatid disease, association of surgery and pre-surgical chemotherapy is a rare approach, pointing out the persistence of an obsolete curative pattern.