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  • Title: [Clinical and parasitologic specifics of echinococcosis in children and teenagers: 68 cases].
    Author: Lazăr L, Căpăţînă A.
    Journal: Bacteriol Virusol Parazitol Epidemiol; 2005; 50(1-2):17-25. PubMed ID: 17300027.
    Abstract:
    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.
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