Pulmonary Echinococcus in children: a descriptive study in a LMIC
Date
2021-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
Background: Echinococcus granulosus is a major public health problem in lower middle-
income countries (LMIC). Children are commonly diagnosed with cysts in the lungs and/or the
liver.
Objectives: The purpose of this study was to describe a pediatric cohort diagnosed with
pulmonary cystic echinococcus (CE) and treated with a combination of medical and surgical
therapy.
Methods: This was a retrospective study performed between July 2017 and December 2020 at
Tygerberg Hospital, South Africa. Clinical, laboratory, radiological, medical, and surgery-related
outcomes were reviewed.
Results: The cohort consisted of 35 children, 17 (49%) were male, with a mean age of 9 ±5.4
years and a mean weight of 20.3 ±8.3 kg. The most frequently encountered presenting symptom
was cough (93%) followed by fever (70% ). Isolated pulmonary CE accounted for the majority
of cases (74%) with left lower lobe predominance. A significant proportion of the cohort
exhibited chest computed tomography (CT) characteristics consistent with complicated
pulmonary CE. Eighteen (58%) children had a positive indirect hemagglutination assay test
result. All children received medical treatment whilst 3 0 (86%) of children required surgery.
Children with complicated pulmonary CE stayed a mean of 12.5 ±6.6 days, while those with
simple cysts stayed 6.8 ±1.5 days.
Conclusion: Isolated pulmonary CE is common in children, whereas extrapulmonary cysts are
uncommon. Pulmonary CE is diagnosed using CXR, and CT imaging. IHA serology has limited
diagnostic utility for pulmonary CE. Combined surgery and chemotherapy remain the gold
standard for treating pulmonary CE.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
Description
Thesis (MMed)--Stellenbosch University, 2021.
Keywords
Pulmonary Echinococcus, Echinococcus granulosus, Lower middle income countries (LMIC), UCTD, Echinococcus -- Children, Hydatid cysts