Spinal cysticercosis: an unusual presentation.

Spinal intramedullary cysticercosis is an uncommon clinical condition that may mimic an intramedullary tumour and can lead to irreversible neurological deficits if untreated. We report a case of a 35-year-old man who clinically presented as Brown-Sequard syndrome, having thoracic cord cysticercosis at T11 level. MRI of the spine revealed a well-defined round intramedullary inflammatory lesion with scolex and perilesional oedema at D11 level.

Primary spinal hydatid disease.

Primary spinal hydatid disease is rare. Spinal hydatid disease should be considered in the differential diagnosis of spinal cord compression syndrome in endemic countries and evaluated with imaging and serology. Our case was a 34- year-old man. The patient presented with progressive back pain for 8 months and lower extremity weakness for 3 months. Neurological examination was suggestive of upper motor neuron type of paraperesis. Magnetic resonance images of the thoracal region showed an intradural multicystic lesion. The mass was explored with T 10-11 laminectomy. It had displaced the cord to the right side. The fluid was clear and did not contain pus. The lesion was easily dissected from the cord and was resected totally. The pathological diagnosis was hydatid disease.

[Blackwater fever in adults with sickle cell anemia. Two fatal cases]. / Fièvre bilieuse hémoglobinurique chez l'adulte drépanocytaire. A propos de deux cas mortels.

Blackwater fever is characterized by severe intravascular hemolysis with renal failure caused by recurrent use of quinine for prophylaxis. Once described in European patients, sporadic cases have been reported more and more often in autochthonous Africans and Asians. Newer antimalarials including aminoalchohol mefloquine, and halofantrine have also been implicated in Blackwater fever. In this report we describe two cases of blackwater fever involving patients with sickle cell anemia (HbSS). Symptoms including fever, acute hemolytic anemia, emesis, back pain, and hemoglobinuria were characteristic of blackwater fever. Both patients died. Although the underlying mechanism of blackwater fever remains unclear, a likely explanation is an immunoallergic reaction to quinine. Association with glucose-6-phosphate dehydrogenase deficiency has often been reported. Our cases suggest that blackwater fever may also be correlated with hemoglobinopathy such as HbSS.

A viable residual spinal hydatid cyst cured with albendazole. Case report.

Spinal hydatid disease is a rare entity that frequently yields to severe, acute-onset neurological deficits. Although the gold standard treatment is total surgical removal of the cysts without inducing any spillage, it may not be possible to perform this in patients with multiple and fragile cysts. In such cases, the neural structures should be adequately decompressed and albendazole should be administered promptly. The authors describe the case of a 13-year-old girl who was admitted with a history of back pain and acute-onset lower-extremity weakness. Magnetic resonance imaging scans demonstrated severe spinal cord compression caused by multiple cysts involving T-4 and the mediastinum. The patient underwent surgery, and the cysts were removed, except for one cyst that was hardly exposed. Following histopathological confirmation of spinal hydatid disease, she was treated with albendazole for 1 year. One year postoperatively, the residual cyst had gradually shrunk and had almost disappeared. Although a single case is not sufficiently promising, we believe that administration of albendazole is efficient to prevent recurrences in cases in which it is not possible to obtain total removal of the cysts without inducing spillage.