Peritoneal Hydatid Cysts in Children: A Case Series of Rare Echinococcosis Localization.

Peritoneal hydatid cysts are rare in children even in endemic areas. The primary or secondary origin of this site remains controversial, especially in children. Secondary peritoneal hydatid cysts are mainly the result of spontaneous or traumatic rupture of concomitant liver cysts or the leakage of cystic content during surgery. The purpose of our study is to present the largest case series of peritoneal hydatidosis in children. In addition, we aimed to assess the clinical and paraclinical findings as well as the management of echinococcosis at this location in children. The present case series is a study of ten children with peritoneal hydatid cysts, who underwent surgical intervention between 2013 and 2018 in the Pediatric Surgery Department, University of Monastir (Monastir, Tunisia). The mean age of the children was six years. All children presented abdominal pain, and underwent ultrasonography and contrast-enhanced computed tomography of the abdomen. Two patients had been operated on for lung hydatid cysts six months prior to the study. In two cases, radiologic investigations revealed the presence of an uncomplicated hepatic hydatid cyst located in segments II and IV. All patients underwent surgery, of which four underwent laparoscopy. Post-surgery, all patients received albendazole for three months, and the follow-up period was uneventful. Currently, all patients are in good health. Peritoneal hydatid disease is frequently secondary to the rupture of a primary hepatic cyst. Diagnosis is performed by abdominal ultrasound, computed tomography, and a positive serology result. Open or laparoscopic excision can be combined with medical treatment.

[Transformation of the fungus Paecilomyces variotii and the causes of host cell lysis at the boundary with a fungal mycelium-containing Echinococcus capsule].

Experiments were carried out on animal species. The experiments used 30-day chicks, 80 rats, and 70 rabbits. Three hundred and twenty-nine patients with echinococcus complicated by paecilomycosis were meticulously examined. The fungi of the genus Paecilomyces undergo two transformation directions: the saprotrophic mycelial form of the fungus Paecilomyces variotii transforms to the tissue parasitic one as a globular form of spherules that transforms to the mycelial form in larval Echinococcus infection because the cyst capsule is a favorable environment for growth of fungal mycelia. The growth and aggressiveness of larval Echinococcus in the human lung are associated with the fact that fungal mycelial fibrous tunic contains Paecilomyces that have been first used to isolate active hyaluronidase that lyses host cells. Pulmonary echinococcosis complicated by the tissue form of paecilomycosis can be complicated by the mycelial form of the fungus of the genus Paecilomyces, by afflicting the nails and skin of patients, which requires particular treatment after surgery for hydatid disease. The chicks that had been brooded in an incubator and grown under special conditions to rule out fungal infection were first contaminated with the fungal mycelium labeled with methionine, sodium sulfate, sodium phosphate, or iodine. Each chick received 0.5 g of the labeled fungal mycelium. Regardless of the contamination mode, all the chicks from 3 groups were infected with Paecilomyces; the spherules exhibited labeled isotopes. Thus, it has been first conclusively proven that the diagnosis of paecilomycosis based on the blood detection of fungal globular spherules is valid and easy-to-use in any health care facility.