Reviews on Trichinellosis (II): Neurological Involvement

Neghină, Adriana Maria; Marincu, Iosif; Iacobiciu, Ioan

doi:10.1089/fpd.2010.0733

Cited by 23 publications

(19 citation statements)

References 53 publications

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“…6 Findings on imaging typically improve within 1 to 2 months of infection. 4 The CT and MRI findings in our case were consistent with what has been previously described and were suggestive of ischemic injuries of varying ages. MRI findings of neurotrichinosis are nonspecific but argue against alternate diagnoses in our case: the absence of significant edema surrounding the lesions is inconsistent with septic emboli or metastases; the dense enhancement of lesions over a long period of time is inconsistent with ischemic embolic lesions; the absence of abnormal blooming on T2 gradient echo sequences speaks against mycotic aneurysms; and the absence of leptomeningeal enhancement is inconsistent with sarcoidosis or other granulomatous disease.…”

Section: Oy-sterssupporting

confidence: 91%

“…Trichinella infection of the CNS, referred to as neurotrichinosis, occurs in as few as 0.2% but as many as 52% of cases and represents serious infection. 4 Neurologic signs and symptoms are nonspecific and range from encephalopathy to hemiparesis and ataxia. For this reason, neurotrichinosis is clinically underrecognized.…”

Section: Oy-stersmentioning

confidence: 99%

“…7 There is no predilection for specific areas of the CNS. 4 Vascular changes, primarily microinfarctions, are thought to be most responsible for neurologic injury and may be mediated by the hypereosinophilic state. 5,6 In previous reports, CT imaging of the brain revealed multifocal hypodensities in the cerebral cortex and white matter.…”

Section: Oy-stersmentioning

confidence: 99%

“…4 The prognosis of patients with neurologic complications of trichinosis is variable, and, despite treatment, some patients have chronic sequelae. Mortality is as high as 5% when the CNS is involved.…”

Section: Oy-stersmentioning

confidence: 99%

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Pearls & Oy-sters: A rare case of neurotrichinosis with MRI

2014

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Pearls & Oy-sters: A rare case of neurotrichinosis with MRI PEARLS 1. The neurologic manifestations of trichinosis are diverse and range from encephalopathy to cerebral, cerebellar, and spinal cord abnormalities. 2. MRI lesions enhance with contrast and are postulated to represent small areas of infarction. 3. Imaging typically normalizes within 1 to 2 months after infection. OY-STERS1. Neurotrichinosis should be considered in patients with marked eosinophilia and unexplained neurologic symptoms. 2. Outcomes may be improved with the administration of steroids and anthelmintic agents during the enteral phase of infection.CASE REPORT A 41-year-old left-handed man from a northern Canadian district presented to a community hospital with a 3-week history of watery diarrhea, a self-resolved erythematous pruritic rash, fever, confusion, and facial swelling. A CT scan of the head showed areas of decreased attenuation bilaterally in the periventricular regions of the frontal lobes. He was offered admission for workup but declined and was sent home with antibiotics. He returned to the hospital 3 days later with new complaints of left face numbness as well as left arm numbness, weakness, and clumsiness. His partner noted that he was sleeping more than usual and had word-finding difficulties. Other symptoms included daily bifrontal headache, "red spots" briefly appearing in his visual field, and ataxia. Medical history was significant for vasectomy, 20-pack-year smoking history, and headaches. He had no allergies and no regular medications.On admission, vital signs were within normal limits, and there was no documented fever. Cardiorespiratory and abdominal examination results were normal. There was no facial edema or skin lesions. Cognition was intact. He had a normal cranial nerve and sensory examination. Strength in the left upper extremity was decreased to 4/5 in all muscle groups. The remainder of the strength examination was normal. Reflexes were present and symmetric. There was a left-sided pronator drift, slowing of finger-to-nose testing, and inability to perform rapid alternating movements with the left arm. Gait was unstable, and the patient used a wheelchair to mobilize in the hospital.Laboratory tests were remarkable for a leukocyte count of 15.3 3 10 9 /L, an eosinophil count of 5.8 3 10 9 /L (38%), platelets of 147 3 10 9 /L, creatine kinase of 290 U/L, troponin of 3.12 mg/L, and erythrocyte sedimentation rate of 34 mm/h. There was no evidence of ST elevation on ECG, and chest x-ray was normal. CSF analysis showed glucose of 57.6 mg/dL, protein 34 mg/dL, erythrocytes 9.5/mm 3 , leukocytes 3.6/mm 3 , and a negative Gram stain and culture. There were too few leukocytes in the CSF to provide a differential. Blood cultures, stool culture, and stool for ova and parasites were all negative. Rheumatologic markers were negative. Echocardiogram showed normal ventricular and valvular function. An EEG showed slow-wave activity in the left temporal region. There was no epileptiform activity.Brain MRI (figure) demonstrate...

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Section: Oy-sterssupporting

confidence: 91%

Section: Oy-stersmentioning

confidence: 99%

Section: Oy-stersmentioning

confidence: 99%

Section: Oy-stersmentioning

confidence: 99%

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Pearls & Oy-sters: A rare case of neurotrichinosis with MRI

2014

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“…Foodborne Pathogens and Disease, which commented on our work ''Reviews on Trichinellosis (II): Neurological Involvement'' (Neghina et al, 2010). Its content is referring particularly to the closing remark of our review (''.…”

mentioning

confidence: 98%