Bruns' syndrome and racemose neurocysticercosis: a case report / Síndrome de Bruns e neurocisticercose racemosa: relato de caso

Cysticercosis is an infection caused by the larval stage of the tapeworm Taenia solium. The parasite may infect the central nervous system, causing neurocysticercosis (NCC). The clinical manifestations depend on load, type, size, location, stage of development of the cysticerci, and the host's immune response against the parasite. The racemose variety occurs in the ventricles or basal cisterns and is a malignant form. Mobile ventricular mass can produce episodic hydrocephalus on changing head posture with attacks of headache, vomiting, and vertigo, triggered by abrupt movement of the head, a phenomenon called Bruns' syndrome (BS). We report a patient with racemose NCC and BS.

A infecção por cisticercose é causada pelo estágio larval da Taenia solium. O parasita pode infectar o sistema nervoso central, causando neurocisticercose (NCC). As manifestações clínicas dependem da quantidade, tipo, tamanho, local, estágio de desenvolvimento do cisticerco e resposta imune do hospedeiro contra o parasita. A variedade racemosa ocorre nas cisternas ventriculares ou basais e é considerada uma forma maligna. O cisticerco móvel no ventrículo pode produzir hidrocefalia episódica com ataques de cefaléia, vômitos e vertigem, provocados pelo movimento abrupto da cabeça, fenômeno chamado de síndrome de Bruns (SB). Relataremos o caso de uma paciente com NCC racemosa com SB.

Gordius Worm Found in a Three Year Old Girl's Vomitus

Since the Gordius worm is a parasite of crickets and several arthropods, cases of humans infected with this worm have been rare and accidental. A Gordius worm was obtained from a three-year-old girl who consulted a local clinic in Gwangju, Kyunggi-do, Korea. She lived in a rural area, and had eaten an insect that looked like a cricket. She expelled the worm in vomitus 15 minutes later; in fact, she expelled two worms, but one was discarded. The worm had a grayish white color and an intact outer surface. It was 16 cm in length and 0.6 cm wide. The posterior end of the worm was spirally enrolled and furcated into two caudal lobes, which were nearly cylindrical but showed a somewhat concave medio- ventral surface. The cloacal aperture was round and situated anterior to the point of bifurcation of the lobes. The cloacal aperture was encircled by a dark ring, which was a little removed from the aperture. The crescent fold was reddish brown, and no hairs were noticed over the entire body surface. The worm had the morphological features of a male Gordius. Accidental human cases involving the Gordius worm are rare and this is the first such case in Korea.

Intestinal strongyloidiasis--a rare opportunistic infection.

We describe the features of intestinal strongyloidiasis in six patients; five of them were immunosuppressed (four on corticosteroids, one with chronic renal failure). Vomiting and diarrhea were the predominant symptoms. Duodenal mucosa on endoscopy varied from normal to severe ulceration. Albendazole 400 mg/day for two weeks was effective. This condition should be considered in immunosuppressed individuals with gastrointestinal symptoms, especially since these symptoms may be mistakenly attributed to the underlying disease.

Oral expulsion of Taenia saginata.

We report a 25-year-old woman who presented with abdominal pain, vomiting and fever, and had an epigastric lump on examination. At laparotomy she was diagnosed to have acute segmental jejunitis. Three days postoperative, she vomited a 2-meter-long tapeworm (Taenia saginata), a rare route of expulsion.

Caso de Moniliformis Moniliformis (Acanthocephala) em criança na Cidade de Säo Paulo / Moniliformis moniliformis (Acanthocephala) from a child in Säo Paulo, Brazil

Em abril de 1994 foi encaminhado ao Laboratório de Enteroparasitoses do Instituto Adolfo Lutz, para identificaçäo, um verme eliminado por criança do sexo feminino, de 12 meses de idade, que vinha apresentando quadro de diarréia, vômito e perda de peso. O exemplar foi examinado em miscroscópio estereoscópio e após estudos biométricos morfológicos, foi classificado como fêmea do gênero Moniliformis moniliformis, Acanthocephala, parasita comum do rato e que pode, acidentalmente, parasitar o homem. O objetivo do presente trabalho é relatar o segundo caso de parasitismo humano no Brasil e chamar a atençäo para a ocorrência eventual do parasita em nosso meio.