Hydatid disease in children: Our experience

Summary Background/Introduction Hydatid disease is relatively uncommon in children. The liver and lungs are most commonly involved, while involvement of other sites in the body is unusual. Purpose(s)/Aim(s) To study the presentation of hydatid disease in children, evaluate the risk factors, and derive appropriate management recommendations for prevention of recurrence and disease control. Methods This was a retrospective study performed from April 2006 to April 2014 in three pediatric institutes. Results There were 18 cases of hydatid disease in children; their age ranged from 7 to 16 years, and the male to female ratio was 8:1. All 18 patients were from a rural background or a farming community and of low socioeconomic status. Cattle rearing was common to the households of all patients. Nine (50%) patients had isolated liver hydatid cyst and three (16.7%) had isolated primary lung hydatid cyst. Two (11.1%) patients had multiple cysts with lung and liver involvement, while four (22.2%) had unusual presentation, i.e., primary hydatid cyst of the spleen in three (16.7%) and primary hydatid cyst of the brain in one (5.5%). All cases were managed surgically and there was no recurrence in any of our patients. Conclusion Hydatid disease is not rare in the pediatric age group. The liver and lung are commonly involved, but it may also present as primary disease in unusual sites like the spleen and brain. Proposed risk factors are rural background, farming community, low socioeconomic status, cattle rearing, lack of supply of potable water, and male sex. Intrinsic defects in the filter mechanism of the liver and lungs, dissemination through enteric lymphatic channels, and patency of the ductus arteriosus in early infancy are the proposed causes of unusual presentation of hydatid disease in children. During cyst removal, spillage of the contents must be avoided to prevent recurrence. Community-based measures are recommended for prevention and disease control.