Should Paediatricians Be Aware of Cystic Echinococcosis? A Literature Review

Among parasitic hepatic cystic lesions, the most common disease is represented by cystic echinococcosis, especially in high endemic countries. European epidemiology of cystic echinococcosis in children is very difficult to assess because of under-reporting but is increasing, because of high immigration flows from endemic countries and an increased awareness. Hydatidosis can be localized in every part of the body. The liver and lungs are the most common localizations in both children and adults. Multi-organ involvement is rarely reported in children. Different tests are available. Usually the sensitivity of serological screening tests is variable, ranging between 60 and 90%. The immunoblot assay is used as a confirmatory test because of its higher sensitivity and specificity. Radiological tests are the gold standard for diagnosis of cystic echinococcosis, with an ultrasound accuracy of about 90%. In case of inactive and uncomplicated cysts the watch-and-wait approach is recommended. Albendazole, currently used for three to six months consecutively represents the most commonly used drug in children even if there is limited experience in treating children under six years of age. Percutaneous treatment with the puncture, aspiration, injection and re-aspiration technique is a minimally invasive procedure. Surgery is indicated based on cyst characteristics in case of big cysts with multiple daughter cysts, single superficial cysts at risk of spontaneous or traumatic rupture, cysts related with the biliary tract in which the percutaneous treatment is contraindicated and cysts compressing related structures. Address correspondence and reprint requests to Luisa Galli, MD, Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Viale Pieraccini 24, I-50139, Florence, Italy (e-mail: luisa.galli@unifi.it). Received 7 August, 2018 Accepted 8 October, 2018 Funding: none. Conflict of interest: none. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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