Total intravenous anaesthesia in a goat undergoing craniectomy.

BACKGROUND: Cerebral coenurosis is a disease of the central nervous system in sheep and goats, and is usually fatal unless surgical relief is provided. Information regarding neuroanaesthesia in veterinary medicine in goats is scant. CASE PRESENTATION: We describe anaesthetic management of an intact female goat (2 years; 16 kg) presented for craniectomy. The goat was sedated with xylazine (0.05 mg kg-1, i.m.) and morphine (0.05 mg kg-1, i.m.). General anaesthesia was induced 20 min later with propofol and maintained with a constant rate infusion of propofol (0.2 mg kg-1 min-1). A cuffed endotracheal tube was placed and connected to a rebreathing (circle) system and mechanical ventilation with 100% oxygen was initiated. A bolus of lidocaine (1 mg kg-1), midazolam (0.25 mg kg-1) and fentanyl 2.5 µg kg-1 was delivered via the intravenous route followed immediately by a constant rate infusion of lidocaine (50 µg kg-1 min-1), midazolam (0.15 mg kg-1 h-1) and fentanyl (6 µg kg-1 h-1) administered via the intravenous route throughout surgery. Craniectomy was undertaken and the goat recovered uneventfully. CONCLUSION: Total intravenous anaesthesia with propofol, lidocaine, fentanyl and midazolam could be an acceptable option for anaesthesia during intracranial surgery in goats.

Clinical evolution of cerebral coenurosis from invasive to chronic infection in sheep and a goat.

This survey describes the evolution in vivo of Coenurus cerebralis in small ruminants. At presentation, neurological signs and cerebrospinal fluid (CSF) features were suggestive of multifocal or diffuse inflammatory reaction. Magnetic resonance imaging (MRI) captured the transition between the invasive and quiescent phase of the infection, revealing the concurrent presence of meningitis and small cysts. During the quiescent phase, in all animals, neurological symptoms disappeared, and cerebrospinal fluid was unremarkable while cysts grew progressively. Subsequently, the onset of neurological symptoms coincided with MRI signs of diffuse or localized increase of intracranial pressure, as confirmed by direct intracranial pressure measuring. All the animals had an excellent post-surgical recovery. This is the first report describing the evolution of coenurosis in vivo. Sequential imaging allowed describing interesting such as the death of some coenuri and different parasite growth rate in the same host.

Unusual clinical case: extraluminal manifestation of a tapeworm from the eviscerated midline incision in a post-surgery patient.

Taenia saginata infestation is one of the most common cestode infestations in humans, that may cause gastrointestinal tract related complications as a result of obstruction, perforation or anastomotic leakage. A 55-year-old male patient who was receiving palliative chemotherapy for stage IV gastric cancer was admitted to the emergency department for abdominal pain. A hollow viscus organ perforation was diagnosed and an emergency surgery was performed. On postoperative day 5, the patient's midline incision eviscerated and a moving taenia emerged, with abundant particulated fluid from the incision line. The patient was admitted for abdominal surgery due to suspected bowel perforation. During the abdominal exploration, a relaxed purse stitch of the feeding tube was observed and no other bowel perforations were seen. The patient underwent two planned surgery for abdominal cavity lavage after the removal of cestode. Unfortunately, the patient died sixteen days after his admission to the intensive care unit. This is the first case describing an extraluminal manifestation of a tapeworm in a midline incision from evisceration without intestinal perforation.

Taenia multiceps brain cyst removal in two wild Nubian ibex (Capra nubianas).

Two wild adult Nubian ibex (Capra nubiana) were captured and admitted to the Hebrew University Veterinary Teaching Hospital with various neurologic signs, including alerted mentation, head tilt, and pathologic nystagmus. The lesion in the central nervous system was localized to the forebrain in one ibex and to the cerebellum of the other. Both ibex's were diagnosed with brain cyst using computed tomography (CT). Craniectomy was performed to remove the cysts, and both animals returned to their natural environment after a rehabilitation period. Parasitologic examination revealed cysts of Taenia multiceps coenurus. This is the first report to describe the neurologic signs, CT findings, surgical procedure, and follow-up postsurgery information in wild Capra nubiana.

Coenurus cerebralis cyst in the orbit of a ewe.

A 4-year-old Rahmani breed ewe was presented for surgery to the Veterinary Teaching Hospital, South Valley University, Egypt with enlargement and protrusion of the eye ball, blepharitis and congestion of the conjunctiva. On examination, a cyst 2.5 cm x 3.5 cm in diameter containing sandy fluid was detected in the perioptic nerve fat. Histopathological examination revealed that the epithelial lining of the conjunctiva was necrotic and severely infiltrated by neutrophils. The underlying connective tissue was oedematous, hyperaemic and severely infiltrated by neutrophils. Desquamation of the corneal epithelium was seen, together with oedema of the stroma. The tissue surrounding the cyst was compressed and the lacrimal glands revealed pressure atrophy. The muscular tissue was atrophied and infiltrated by fat cells. The cyst wall was lined with white scolices protruding from the inner wall. Based on the gross and histopathological characteristics of the cyst observed, the cyst was diagnosed as Coenurus cerebralis. This is the first report of orbital coenurosis in a sheep.

Diagnosis and treatment of coenurosis in sheep.

Coenurosis is a disease of the central nervous system in sheep, caused by Coenurus cerebralis, the larval stage of Taenia multiceps, a tapeworm, which infests the small intestine of carnivores. In 80-90% of cases, the cyst is located in one cerebral hemisphere, whilst in 5-10% of cases, it is localised in the cerebellum; rarely it involves two sites in the brain of the affected animal. Listeriosis, louping-ill, sarcocystosis and polioencephalomalacia and brain abscessation should be considered when formulating a diagnosis of acute coenurosis. In all cases, it is essential to carefully examine the animal and not simply rely on results of ancillary tests (mainly of cerebrospinal fluid examination), as disorders other than coenurosis can be responsible for changes in the results of these tests. Treatment is based on surgical removal of the coenurus cyst after general anaesthesia of the animal; the approach has a very good success rate, especially after accurate localisation of the lesion. Despite that, many farmers may choose to slaughter those sheep fit for marketing for economic reasons and euthanise those in poor condition.

Infection with the strobilocercus of Taenia taeniaeformis in a Malagasy giant jumping rat (Hypogeomys antimena).

An adult male Malagasy giant jumping rat (Hypogeomys antimena) kept at Zoo Duisburg was presented for clinical examination because of a distended abdomen and a history of lethargy and weakness. General examination findings consisted of an enlarged soft and fluctuating abdomen, suggestive of ascites. Digital radiography revealed multiple cloud-like radiopaque lesions in the cranial abdominal area, as well as an overall decrease in visibility of detail of the abdominal organs. Ultrasound examination showed circumscribed hypo- to anechogenic areas in the liver, measuring from 1 to 3 cm in diameter, some containing irregular, convoluted structures. Exploratory laparotomy confirmed the presence of a large amount of clear, pale-yellow fluid in the peritoneal cavity, as well as multiple cystic lesions in the liver and in the greater omentum. Extirpated cysts placed in sterile saline solution or fixed in formalin were sent to the Institut für Parasitologie der Tierärztlichen Hochschule, Hannover, Germany, and were identified as larval stages of the cestode Taenia taeniaeformis. Unfortunately, the rat died a few hours after surgery. To the authors' knowledge, this is the first report of infection with strobilocerci of T. taeniaeformis in a Malagasy giant jumping rat.

[Imported coenurosis in sheep]. / Importierte Coenurose beim Schaf.

Thirteen sheep from a milk producing farm in the Canton of Grisons that presented chronic coenurosis were examined and subjected to treatment trials at the veterinary hospital in Zurich. Symptoms were first observed around two months after the import of two dogs from Italy (Abruzza) of which one was infected with Taenia multiceps and Echinococcus granulosus. The most frequently observed clinical symptoms of the sheep were reduced general condition, circling, reduced menace reflex, apathy, unsteady gait and head tilt. Analyses of cerebrospinal fluid revealed an increased leucocyte count in 3 sheep and eosinophilia in 4 sheep. In 4 animals that underwent computertomography, one or more hypodense, definable lesions were found in the brain. In 2 sheep surgical treatment and in 10 animals medical treatment with either Praziquantel (n=8) or Oxfendazol (n=2) was attempted. Only one animal treated with Praziquantel needed not to be euthanized. At necropsy, one or two coenurus cysts could be found either in a side ventricle (n=2), in the cerebellum (n=3) or in the cerebrum (n=7). The locations corresponded with the clinical findings. Despite Praziquantel or Oxfendazol treatment, living protoscoleces could be found in the parasite cysts.

Case report: human brain abscess due to a tetra-acetabulate plerocercoid metacestode (Cyclophyllidea).

A 38-year-old man living near Phnom Penh (Cambodia) was admitted to a hospital in Paris in June 2001 for a single episode of a generalized grand mal seizure. This episode was preceded by a 9-month history of headaches. Magnetic resonance imaging (MRI) of the head revealed a rounded lesion immediately ahead of the left central sulcus. The resected lesion was about 20 mm in diameter. Histologic examination revealed an elongated but unsegmented metacestode at the center of the lesion. Polymerase chain reaction (PCR) analysis was inconclusive due to formalin-based histologic processing of the tissue. Morphologic analysis based on the histologic sections revealed that the metacestode was a tetra-acetabulate plerocercoid of the order Cyclophyllidea, with a distinct rostellum and pseudosegmentation of the dorsoventrally flattened hindbody. This is the first report of a tetra-acetabulate plerocercoid from a human host and the first report of any cyclophyllidean plerocercoid from the human brain. After 6 weeks, the patient was asymptomatic, neurologic examination was normal, and the brain MRI showed only surgical cavitation. The patient returned to Cambodia.

[A case of cerebral coenurosis]. / Su di un caso di cenurosi cerebrale.

In this article the authors describe a case of cerebral coenurosis, a rare infection caused by the larval stage of the tapeworm Taenia multiceps, encountered during their professional practice. The specific epidemiological elements, linked to the parasitic lifecycle in dogs, will also be covered. The authors consider the diagnostic, pathologic and clinical elements that allow differential diagnosis with respect to neurocysticercosis, a parasitic infection caused by the larval form of other Cestoda, discussing possible medical therapeutic approaches (albendazole or praziquantel) and neurosurgical intervention. They emphasize the need to obtain a correct hystopathological diagnosis in order to achieve a differential diagnosis versus the other larval parasitosis. According to current public health regulations this diagnosis must be reported to the Health Official to allow the necessary epidemiological interventions to be planned.

Long-term follow-up of the surgical treatment of intracranial coenurosis.

Intracranial infestation by the coenurus of the tapeworm Taenia multiceps is a rare occurrence in humans, with about 55 cases having been reported so far. Although most of these cases were observed in African or South American countries, the illness was occassionally found also in sheep-raising areas of Western Europe and the United States. Out of 4 personal cases, who were operated upon over an 18-year-period, 2 were neurologically intact respectively 20 and 3 years following surgical treatment. CT scans confirmed the absence of a progression of the disease. One patient was able to work 6 years after surgery, when he was killed in a road accident. A further, severely impaired patient remained unchanged and died with intercurrent infection 10 years following the operation.

Clinical and radiographical diagnosis of coenurosis cerebralis in sheep and its surgical treatment.

During the period between November 1982 and April 1984, 11 sheep showing clinical signs of infection by Coenurus cerebralis were subjected to clinical and radiographical examinations, and subsequently treated surgically for removal of the cyst. A detailed account is given of the investigations carried out and of the surgical procedure adopted for the removal of the cyst together with cystographical and surgicopathological findings. There was a successful clinical response to the removal of the cyst.

Diagnosis and treatment of coenuriasis (gid) in sheep.

A procedure for the clinical investigation and surgical treatment of cases of coenuriasis in sheep was assessed. The results were based on a series of 62 cases of coenuriasis, of which 58 per cent did not have any palpable skull softening. A useful correlation between the neurological signs and the location of cysts was demonstrated, enabling accurate localisation of cysts in 68 per cent of cases. The surgical technique for the removal of cysts gave a success rate of 74 per cent among the 42 cases selected for surgery, as judged by the complete removal of the cyst and recovery of neurological functions.