Dual Cestode Infection in a Thai Patient (Spinal Sparganosis and Racemose Neurocysticercosis): A Case Report

Abstract

Patient: Male, 41Final Diagnosis: Spinal sparganosis and racemose neurocysticercosisSymptoms: Hip pain • numbness • weakness • blindness • hearing lossMedication: —Clinical Procedure: LaminectomySpecialty: Infectious DiseasesObjective:Rare diseaseBackground:Spinal sparganosis and racemose (grape-like) neurocysticercosis are rare diseases. Co-infection with spinal sparganosis and racemose neurocysticercosis has never been reported in the English-language literature.Case Report:A 41-year-old male presented after having experienced left hip pain with radiation to the leg, progressive weakness and numbness of the left leg, and difficulty urinating for 4 years, all of which was caused by spinal sparganosis. He had also experienced progressive vision and hearing loss on the right side for 3 years, which were caused by racemose neurocysticercosis. Magnetic resonance imaging (MRI) of the lumbosacral spine and the brain revealed intrinsic spinal cord lesion and racemose neurocysticercosis, respectively. Spinal sparganosis was diagnosed by histological examination and an immunochromatographic test. It was treated with a high-dose of praziquantel (75 mg/kg/day) combined with cimetidine; without clinical improvement. Treatment consisted of racemose neurocysticercosis with albendazole for 2 months. A follow-up MRI of the brain revealed a minimal reduction in the amount of racemose neurocysticercosis. Repeat treatment with albendazole was administered. However, further MRI examination of the brain revealed the condition to be unchanged. Vision and hearing loss had also not improved.Conclusions:In this case report, we describe a middle-aged man who presented with spinal cord symptoms (hip pain, progressive weakness and numbness of the leg, and difficulty urinating) and cranial nerve palsies (vision and hearing loss) caused by spinal sparganosis and racemose neurocysticercosis, respectively. Neurological symptoms did not improve with anthelmintic drugs.

Case report: Magnetic resonance tracing reveals migratory patterns of cerebral sparganosis mansoni in a child with corpus callosum invasion

“…The cerebrospinal uid system is extensive, providing the worms with numerous possible trajectories. In severe cases, the brain parenchyma (such as this case) and spinal cord 15 are invaded, further increasing the di culty of treatment.…”

Sparganosis parasitic tumor: Resectability and postoperative outcome, and analysis of cases from an endemic area in Indochina

“…The analysis shows that there are 50 published instances of sparganosis overall in the study area. [1][2][3][4][5][6][7][8][9] According to one investigation, sparganosis has been described in 34 cases since 1943. Intraperitoneal (1 case), pulmonary (1 case), intraosseous (1 case), ocular (20 cases), subcutaneous (10 cases), central nervous system (CNS) (13 cases), auricular (1 case), and subcutaneous (10 cases) infections were among those reported.…”

Ocular sparganosis: comment

“…Authors should refer to further studies on the possibility of dissemination parasitosis. Second, there may be co-infection with other tissue invading parasites and it is important to be aware of this potential [ 3 ]. Other non-parasitic cause of conjunctiva problem, such as allergic reaction, is also possible.…”