The Return of an Old Worm: Cerebral Paragonimiasis Presenting with Intracerebral Hemorrhage.
10.3346/jkms.2012.27.11.1428
- Author:
Eun Jung KOH
1
;
Seung Ki KIM
;
Kyu Chang WANG
;
Jong Yil CHAI
;
Sangjoon CHONG
;
Sung Hye PARK
;
Jung Eun CHEON
;
Ji Hoon PHI
Author Information
1. Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea. phi.jihoon@gmail.com
- Publication Type:Case Reports
- Keywords:
Cerebral Paragonimiasis;
Intracerebral Hemorrhage;
Diagnosis
- MeSH:
Animals;
Anthelmintics/therapeutic use;
Brain/parasitology/pathology;
Cerebral Hemorrhage/*etiology;
Child;
Dysarthria/etiology;
Facial Paralysis/etiology;
Female;
Humans;
Magnetic Resonance Imaging;
Paragonimiasis/*diagnosis/drug therapy/parasitology;
Paragonimus/isolation & purification;
Praziquantel/therapeutic use;
Tomography, X-Ray Computed;
Vascular Malformations/etiology
- From:Journal of Korean Medical Science
2012;27(11):1428-1432
- CountryRepublic of Korea
- Language:English
-
Abstract:
Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.
