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Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings: a case report and literature review.
BMC Infect Dis 2019; 19(1):748BI

Abstract

BACKGROUND

Sparganosis, a rare and severe parasitic infection caused by the larvae of Spirometra species or simply sparganum, generally involves subcutaneous tissue or muscle. But occasionally, sparganum can also invade the human brain, resulting in cerebral sparganosis.

CASE PRESENTATION

A 33-year-old woman presented with a 10-day history of headache. Postcontrast magnetic resonance imaging (MRI) revealed an irregular lesion with enhancement and the tunnel-shaped focus extending to the contralateral hemiphere. Cerebrospinal fluid (CSF) analysis disclosed pleocytosis (166 cells/μL) and an elevated protein concentration (0.742 g/L). Enzyme-linked immunosorbent assay (ELISA) revealed positive sparganum-specific antibody in both blood and CSF. Finally, the diagnosis of cerebral sparganosis was comfirmed. She received praziquantel treatment and got a favorable outcome during six-month follow-up.

CONCLUSIONS

Irregular enhancement and the tunnel sign that extends to the contralateral hemisphere on postconstrast MRI are unusual presentations of cerebral sparganosis. ELISA for sparganum-specific antibody can help confirm the diagnosis. Although surgery is the preferred treatment for cerebral sparganosis, praziquantel might also achieve satisfying outcomes.

Authors+Show Affiliations

Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. chenyanxing@zju.edu.cn.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

31455261

Citation

Zhu, Yueli, et al. "Cerebral Sparganosis Presenting With Atypical Postcontrast Magnetic Resonance Imaging Findings: a Case Report and Literature Review." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 748.
Zhu Y, Ye L, Ding X, et al. Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings: a case report and literature review. BMC Infect Dis. 2019;19(1):748.
Zhu, Y., Ye, L., Ding, X., Wu, J., & Chen, Y. (2019). Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings: a case report and literature review. BMC Infectious Diseases, 19(1), p. 748. doi:10.1186/s12879-019-4396-2.
Zhu Y, et al. Cerebral Sparganosis Presenting With Atypical Postcontrast Magnetic Resonance Imaging Findings: a Case Report and Literature Review. BMC Infect Dis. 2019 Aug 27;19(1):748. PubMed PMID: 31455261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings: a case report and literature review. AU - Zhu,Yueli, AU - Ye,Lingqi, AU - Ding,Xiansan, AU - Wu,Jimin, AU - Chen,Yanxing, Y1 - 2019/08/27/ PY - 2019/03/07/received PY - 2019/08/21/accepted PY - 2019/8/29/entrez PY - 2019/8/29/pubmed PY - 2019/11/19/medline KW - Cerebral sparganosis KW - ELISA KW - Praziquantel KW - Tunnel sign SP - 748 EP - 748 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 19 IS - 1 N2 - BACKGROUND: Sparganosis, a rare and severe parasitic infection caused by the larvae of Spirometra species or simply sparganum, generally involves subcutaneous tissue or muscle. But occasionally, sparganum can also invade the human brain, resulting in cerebral sparganosis. CASE PRESENTATION: A 33-year-old woman presented with a 10-day history of headache. Postcontrast magnetic resonance imaging (MRI) revealed an irregular lesion with enhancement and the tunnel-shaped focus extending to the contralateral hemiphere. Cerebrospinal fluid (CSF) analysis disclosed pleocytosis (166 cells/μL) and an elevated protein concentration (0.742 g/L). Enzyme-linked immunosorbent assay (ELISA) revealed positive sparganum-specific antibody in both blood and CSF. Finally, the diagnosis of cerebral sparganosis was comfirmed. She received praziquantel treatment and got a favorable outcome during six-month follow-up. CONCLUSIONS: Irregular enhancement and the tunnel sign that extends to the contralateral hemisphere on postconstrast MRI are unusual presentations of cerebral sparganosis. ELISA for sparganum-specific antibody can help confirm the diagnosis. Although surgery is the preferred treatment for cerebral sparganosis, praziquantel might also achieve satisfying outcomes. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/31455261/Cerebral_sparganosis_presenting_with_atypical_postcontrast_magnetic_resonance_imaging_findings:_a_case_report_and_literature_review L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4396-2 DB - PRIME DP - Unbound Medicine ER -