Subject(s)
Brain/pathology , Brain/parasitology , Neurocysticercosis/diagnosis , Neurocysticercosis/parasitology , Taenia solium/isolation & purification , Animals , Benzenesulfonates , Biopsy , Brain/diagnostic imaging , Hemiplegia/parasitology , Humans , Male , Middle Aged , Neurocysticercosis/pathology , Paresis/parasitologyABSTRACT
OBJECTIVE: To identify cases of malaria with unusual presentations. METHODS: The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study. RESULTS: Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds. CONCLUSION: Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.
Subject(s)
Hospitals, Pediatric , Malaria, Falciparum/complications , Malaria, Falciparum/diagnosis , Malaria, Vivax/complications , Malaria, Vivax/diagnosis , Plasmodium falciparum/isolation & purification , Plasmodium vivax/isolation & purification , Abdomen, Acute/parasitology , Adolescent , Child , Child, Preschool , Developing Countries , Early Diagnosis , Edema/parasitology , Female , Gastrointestinal Hemorrhage/parasitology , Headache/parasitology , Hemiplegia/parasitology , Hepatitis/parasitology , Hospitals, University , Humans , Hyperglycemia/parasitology , India , Infant , Intensive Care Units, Pediatric , Intestinal Obstruction/parasitology , Malaria, Falciparum/drug therapy , Malaria, Vivax/drug therapy , Male , Medical Records , Retrospective StudiesABSTRACT
A woman aged 21 years noticed numbness of the left hand, dysarthria, and right hemiparesis. Magnetic resonance imaging (MRI) showed homogeneously enhanced lesions in the bilateral cerebral white matter; these enlarged within 2 weeks, showing ring-like enhancement, and then spontaneously decreased in size and enhancement. Neurocysticercosis was confirmed by repeated, significantly positive serology results and the dramatic response to praziquantel. Subsequently, positron emission tomography (PET) revealed persisting regions of possibly decreased cerebral uptake of [18F]2-fluoro-2-deoxyglucose. This is the first documentation of such distinctive serial MRI changes and the results of PET in neurocysticercosis.
Subject(s)
Brain Diseases/parasitology , Cysticercosis/diagnosis , Magnetic Resonance Imaging , Tomography, Emission-Computed , Adult , Antiplatyhelmintic Agents/therapeutic use , Brain/metabolism , Brain Diseases/diagnosis , Brain Diseases/diagnostic imaging , Cysticercosis/diagnostic imaging , Deoxyglucose/analogs & derivatives , Deoxyglucose/pharmacokinetics , Female , Fluorine Radioisotopes/pharmacokinetics , Fluorodeoxyglucose F18 , Hand , Hemiplegia/parasitology , Humans , Praziquantel/therapeutic use , Sensation Disorders/parasitologyABSTRACT
We report the first case of Chagas' disease causing a brain mass in the acquired immunodeficiency syndrome (AIDS). The illness occurred in a patient living outside a traditional chagasic endemic area and represented reactivation of long dormant Trypanosoma cruzi infection. A Salvadoran-born resident of the United States with diagnosed AIDS developed hemiparesis due to a brain mass. Histopathologic examination and culture of a brain biopsy specimen established that T. cruzi infection produced the lesion. The patient's epidemiologic history excluded newly acquired trypanosomal infection. Thus, cerebral Chagas' disease must now be considered another potential opportunistic infection in AIDS. This is of particular concern as the pandemic spreads to large Latino populations previously exposed to infection with the parasite.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Brain Diseases/parasitology , Chagas Disease/complications , Adult , Diagnosis, Differential , Hemiplegia/parasitology , Humans , MaleABSTRACT
A case of the unusual clinical condition of cerebral coenurosis, the unique parasitic disease that is localized only in the CNS, is reported. The patient had repeated attacks of transient hemiparesis due to intracranial arteritis which was demonstrated by several angiographic studies. The CSF showed a discreet lymphocytosis and increased immunoglobulins. This inflammatory reaction which preceeded the manifestations of the intracranial mass can be explained by the parasitic foreign bodies, the liberation of somatic and metabolic parasitic toxins and the immunological reaction of the organism. The arteritis of the basal intracranial vessels was probably secondary to the inflammatory reaction of the leptomeninges. In presence of the rare association of meningovascular disease and an expanding intracranial lesion a parasitic condition due to a larval stage of Cestodes (Hydatidosis, Cysticercosis, Coenurosis) should be always considered.
