RESUMEN
BACKGROUND: Angiostrongyliasis cantonensis is a severe yet rare parasitic infection caused by the larvae of Angiostrongylus cantonensis. The primary characteristic feature of this foodborne illness in humans is eosinophilic meningitis. Recently, there has been a gradual increase in reported cases globally. Due to the lack of typical clinical symptoms, signs, and specific laboratory tests, early diagnosis of this disease poses significant challenges. Failure to diagnose and treat this condition promptly can result in fatalities. METHODS: We present the case of a 13-year-old male patient who initially presented with fever and headache. The patient was preliminarily diagnosed with bacterial meningitis and received treatment with antibacterial drugs. However, the patient's condition worsened, and he developed progressive consciousness disturbances. Eventually, metagenomic next-generation sequencing (mNGS) testing of cerebrospinal fluid samples indicated Angiostrongylus cantonensis infection. Following treatment with albendazole and prednisone, the patient made a full recovery. We include this case report as part of a literature review to emphasize the potential applications of mNGS in the early diagnosis of Angiostrongyliasis cantonensis. CONCLUSION: mNGS technology plays a crucial role in the diagnosis of angiostrongyliasis cantonensis. As this technology continues to evolve and be applied, we believe it will play an increasingly important role in diagnosing, treating, and monitoring angiostrongyliasis cantonensis.
Asunto(s)
Angiostrongylus cantonensis , Secuenciación de Nucleótidos de Alto Rendimiento , Hidrocefalia , Infecciones por Strongylida , Humanos , Infecciones por Strongylida/diagnóstico , Infecciones por Strongylida/tratamiento farmacológico , Infecciones por Strongylida/complicaciones , Masculino , Angiostrongylus cantonensis/genética , Angiostrongylus cantonensis/aislamiento & purificación , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Adolescente , Animales , Hidrocefalia/diagnóstico , Hidrocefalia/parasitologíaRESUMEN
Purpose Experimental models might help understand the pathophysiology of neurocysticercosis-associated hydrocephalus. The present study aimed to compare the extent of hydrocephalus and tissue damage in rats with subarachnoid inoculation of different concentrations of Taenia crassiceps cyst proteins. Methods Sixty young rats were divided into two groups: low- and high-concentration groups. The animals in the low concentration group received 0.02ml of 2.4mg/ml T. crassiceps cyst proteins while those in the high concentration group received 0.02 ml of 11.6mg/ml T. crassiceps cyst proteins. The animals underwent magnetic resonance imaging at 1, 3, and 6 months postinoculation to assess the ventricle volume. Morphological assessment was performed at the end of the observation period. Results Repeated measures of ventricle volumes at 1, 3, and 6 months showed progressive enlargement of the ventricles. At 1 and 3 months, we observed no differences in ventricle volumes between the 2 groups. However, at 6 months, the ventricles were larger in the high concentration group (median » 3.86mm3, range: 2.3712.68) compared with the low concentration group (median » 2.00mm3, range: 0.3711.57), p » 0.003. The morphological assessment revealed a few inflammatory features in both groups. However, the density of oligodendrocytes and neurons within the periventricular region was lower in the high concentration group (5.18 versus 9.72 for oligodendrocytes and 15.69 versus 21.00 for neurons; p < 0.001 for both). Conclusion Our results suggest that, in rats, a higher concentration of T. crassiceps cyst proteins in the subarachnoid space could induce ventricle enlargement and reduce the number of neurons within the periventricular area.
Asunto(s)
Animales , Ratas , Ventrículos Cerebrales/fisiopatología , Neurocisticercosis/patología , Hidrocefalia/parasitología , Antígenos Helmínticos , Espacio Subaracnoideo/fisiopatología , Taenia , Imagen por Resonancia Magnética/métodos , Ratas Wistar , Estadísticas no Paramétricas , Infecciones Parasitarias del Sistema Nervioso Central , Interacciones Huésped-Parásitos , Hidrocefalia/fisiopatologíaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Neurocisticercosis/complicaciones , Neurocisticercosis/diagnóstico , Ecuador , Hidrocefalia/parasitología , Hipertensión Intracraneal/parasitologíaRESUMEN
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.
Asunto(s)
Adulto , Femenino , Humanos , Ventrículos Cerebrales/parasitología , Cefalea/parasitología , Hidrocefalia/parasitología , Neurocisticercosis/diagnóstico , Vértigo/parasitología , Vómitos/parasitología , Imagen por Resonancia Magnética , Síndrome , Tomografía Computarizada por Rayos XRESUMEN
Cerebral toxoplasmosis remains the most important neurological opportunistic infection and the most common cause of intracerebral mass lesion in patients with acquired immunodeficiency syndrome (AIDS). We report a case of an adult AIDS patient with an atypical pattern of toxoplasma encephalitis, presenting with ventriculitis and obstructive hydrocephalus without any focal parenchymal lesion.
Asunto(s)
Adulto , Femenino , Humanos , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Encefalitis/parasitología , Hidrocefalia/parasitología , Toxoplasmosis Cerebral/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Encefalitis/diagnóstico , Estudios de Seguimiento , Hidrocefalia/diagnóstico , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Toxoplasmosis Cerebral/diagnóstico , Toxoplasmosis Cerebral/tratamiento farmacológicoRESUMEN
Com o propósito de analisar os aspectos clínicos da hidrocefalia (HDC) na neurocisticercose (NCC), realizou-se o estudo retrospectivo de 47 prontuários de pacientes com HDC e NCC. Verificou-se que 70,2 por cento eram homens, entre 21 e 50 anos. A hipertensão intracraniana (HIC) ocorreu em todos os pacientes, cefaléia (CEF) em 89,4 por cento, meningoencefalite (ME) em 80,8 por cento e distúrbios psíquicos (PSI) em 74,5 por cento. A síndrome liquórica da NCC foi detectada em 65,9 por cento pacientes. Além da HDC, as tomografias computadorizadas de crânio (TC) mostraram lesões císticas e edema cerebral difuso em 59,6 por cento cada, calcificações em 55,3 por cento. Dos 41 pacientes (87,2 por cento) com derivação ventriculoperitoneal (DVP), em 22 (53,7 por cento) deles foram necessárias uma a sete revisões/paciente (média=3). A evolução foi satisfatória em 51,1 por cento e fatal em 31,9 por cento. Conclui-se que a hidrocefalia é mais comum no sexo masculino em idade produtiva, tendo a HIC, CEF, MN e PSI como manifestações freqüentes e que, a necessidade de revisões de DVP, piora o prognóstico.
With the purpose to verify clinical aspects of hydrocephalus (HC) in patients with neurocysticercosis (NCC), a retrospective study of 47 patients was performed. The majority of patients (70.2 percent) were men aging 21-50 years. Intracranial hypertension (ICH) occurred in all patients, headache (HA) in 42 (89.4 percent), meningoencephalitis (ME) in 38 (80.8 percent) and psychiatric disorders (PD) in 34 (72.3 percent). The cerebrospinal fluid syndrome of NCC was detected in 31 patients (65.9 percent). In addition to HC, computed tomography (CT) scans showed cystic lesions in 28 (59.6 percent) patients, diffuse brain edema also in 28 (59.6 percent), and calcifications in 26 (55.3 percent). Shunts were inserted in 41 (87.2 percent) patients and 22 (53.7 percent) of them were submitted to 1-7 surgical revision/patient (mean=3) that were higher (mean=4) in those who died than in survivors (mean=2). Evolution was satisfactory in 24 (51.1 percent) patients and fatal in 15 (31.9 percent). It is possible to conclude that, in patients with NCC, HC occurs predominantly in men in productive life with ICH, HA, ME and PD as common manifestations, and the need for shunt revision makes patient's prognosis worse.