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Albendazole Monotherapy for Pediatric Cystic Echinococcosis: A Case Series

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Abstract

Background

Data regarding albendazole monotherapy for cystic echinococcosis (CE) are scarce, especially in children. We report our experience treating CE in children with albendazole monotherapy.

Methods

A retrospective case series, 2005–2021, assessing factors leading to albendazole monotherapy, demographic, clinical, duration of treatment and follow-up, and outcome (changes in cyst size and side effects) characteristics.

Results

Overall, we identified 18 patients with 31 cysts; liver: 68% (n = 21), lungs: 29% (n = 9), and kidney: 3% (n = 1). Mean cyst size was 4.5 ± 2.6 cm. Reasons for administrating albendazole monotherapy were small (< 4 cm) cyst size (56%), difficulty to operate (33%) and comorbidity (22%). Duration of treatment (range 1–32 months) was 1, 2–3, 4–6 and > 6 months in 28% (n = 5), 39% (n = 7), 17% (n = 3) and 17% (n = 3) of children, respectively. Duration of follow up (range 1–87 months) was 1, 2–3, 4–6 and > 6 months in 11% (n = 2), 11% (n = 2), 17% (n = 3) and 61% (n = 11) of children, respectively. Overall, 83% (n = 15) of patients experienced lack of cyst growth, and 72% (n = 13) experienced reduction in cyst size, while 44% (n = 8) experienced reduction larger than 50%. Full resolution was noted in 22% (n = 4) of patients. In three cases (17%) treatment failure was recorded: one (6%) recurrence, and two cases (11%) of cyst growth. Neutropenia was recorded in two patients (11%), and liver enzymes elevation was recorded in six patients (33%).

Conclusions

Albendazole monotherapy may be an adequate treatment for selected cases of CE disease in children, especially in CE with small, hepatic cysts.

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Authors and Affiliations

  1. The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Moshe Shmueli, Siham Elamour, Daniel Grupel, Zaki Assi & Shalom Ben-Shimol

  2. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel

    Siham Elamour & Shalom Ben-Shimol

  3. The Parasitology Laboratory, Soroka University Medical Center, Beer-Sheva, Israel

    Orli Sagi

  4. Internal Medicine B, Soroka University Medical Center, Beer Sheva, Israel

    Daniel Grupel

  5. Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel

    Zaki Assi

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  1. Moshe Shmueli
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Contributions

MS and SBS have made a substantial contribution to the concept or design of the article, or the acquisition, analysis, or interpretation of data for the article. MS, SE, OS, and SBS drafted the article or revised it critically for important intellectual content. MS, SE, OS, DG, ZA, and SBS approved the version to be published. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Shalom Ben-Shimol.

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Shmueli, M., Elamour, S., Sagi, O. et al. Albendazole Monotherapy for Pediatric Cystic Echinococcosis: A Case Series. Acta Parasit. 68, 651–658 (2023). https://doi.org/10.1007/s11686-023-00699-6

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  • DOI: https://doi.org/10.1007/s11686-023-00699-6

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