Animals ; Antibodies, Helminth ; blood ; cerebrospinal fluid ; Child, Preschool ; Eosinophilia ; cerebrospinal fluid ; diagnosis ; etiology ; Female ; Humans ; Meningitis ; cerebrospinal fluid ; diagnosis ; etiology ; Neurocysticercosis ; complications ; drug therapy ; parasitology ; Taenia ; immunology

OBJECTIVETo confirm diagnosis of a special case with chief complaints of abdominal pain and dyskinesia of lower extremities.

METHODSThe clinical symptoms, signs, MRI, pathological findings and the results of blood test for microfilaria were analyzed.

RESULTSThe patient was a 6-year old girl who had abdominal pain for 10 days dyskinesia of lower extremities for 6 days accompanied by difficulty in urination and defecation. There was tenderness on T7-9 spinous process, sensory dullness below the umbilicus. Babinski's and Oppenheim's sign were bilaterally positive, and ankle clonus was positive. MRI showed space occupying change in the vertebral canal at T7-9 level. The mass of 2 cm x 1 cm x 1 cm size was removed by surgical operation and histopathological study showed obvious fibrous tissue proliferation accompanied by eosinophil, lymphocyte and neutrophil infiltration around a worm-like structure. Night time blood test performed at 23:00 confirmed the presence of microfilaria.

CONCLUSIONThe diagnosis of filariae in vertebral canal could be confirmed.

Animals ; Child ; Female ; Filariasis ; blood ; cerebrospinal fluid ; complications ; Filarioidea ; Humans ; Spinal Canal ; parasitology ; pathology ; Spinal Diseases ; etiology ; parasitology

The applicability of micro-ELISA was evaluatd in human neuro-cysticercosis using paired samples of serum and CSF. A total of 355 cases who were mostly neurologic patients was subjected. Cystic fluid of C. cellulosae was used as antigen in protein concentration of 2.5 micro-g/ml. Serum was diluted to 1:100 and CSF was undiluted in the assay for the specific IgG antibody level. The differential criterion of the positive reaction was the abs. of 0.18 in both samples. The results were summarized as follows: The overall sensitivity of the micro-ELISA in 71 confirmed neurocysticercosis was 90.1%; the sensitivity by serum was 77.5% and that by CSF was 83.1%. CSF was a more sensitive and valuable material. Most of the false negative cases of neuro-cysticercosis showed far lower level of abs. rather than marginal. The overall specificity of the micro-ELISA in 52 confirmed other neurologic diseases was 88.5% ; the specificities by serum and by CSF were 94.2% respectively. Cases of other neurologic diseases did not show false positive reactions in both samples. When serum was assayed, taeniasis(2/18), sparganosis(2/20), paragonimiasis(1/56), clonorchiasis(1/15) and fascioliasis(1/1) cases showed cross reactions. When CSF was assayed, 2 of 10 neuro-sparganosis showed cross reactions while none of 9 neuro-paragonimiasis showed it. Out of 71 confirmed neuro-cysticercosis cases, 6 and 11 showed cross reactions by serum and CSF to crude extract antigen of sparganum; but no case did show it to crude extract antigen of Paragonimus westermani. Ventricular CSF showed low or negative levels of IgG antibody than lumbar CSF unless the lesion was at the lateral ventricle itself. Out of 4 racemose cysticercosis cases, 3 showed positive reaction in serum while all of 3 examined CSF were positive. The above results indicated that the serological test for detecting the specific IgG antibody by micro-ELISA using paired samples of serum and CSF was very helpful for clinical differentiation of neuro-cysticercosis from neurologic diseases of other causes.
parasitology-helminth-cestoda ; immunology ; Taenia solium ; cysticercus ; enzyme-linked-immunosorbent assay ; serum ; cerebrospinal fluid ; IgG

The applicability of indirect immunofluorescent antibody test (IFAT) was compared with enzyme-linked immunosorbent assay (ELISA) in sera from 163 cases of confirmed neurocysticercosis, 101 other neurologic and parasitic diseases and 100 normal controls. As antigen, frozen sections of a Taenia solium metacestode from a human brain was used in IFAT and cystic fluid was used in ELISA. For the detection of specific IgG antibody, IFAT was equally sensitive (89. 6%) and specific (85. l%) as ELISA. The antibody titers by IFAT were correspondingly increased with mean absorbance of ELISA. The corresponding rate of positivity in the two techniques was 90.8%. Except for the difficulty in detecting antibodies in cerebrospinal fluid (CSF), IFAT was concluded to be very useful for the serodiagnosis of human neurocysticercosis.
parasitology-helminth-cestoda ; Taenia solium ; cysticercus ; enzyme-linked immunosorbent assay ; cerebrospinal fluid ; brain ; IgG ; immunofluorescence ; immunology

To determine the source of Cysticercus-specific IgG antibody in cerebro-spinal fluid(CSF), paired samples of serum and CSF were collected from confirmed neurocysticercosis, other neurologic diseases and normal control. The antibody levels in serum and CSF were measured by enzyme-linked immunosorbent assay (ELISA). With the measurement of total protein, albumin and IgG concentration in serum and CSF, the contribution of IgG in CSF were calculated in transudation, exudation and intracranial synthesis using the formula of Tourtellotte and Ma (1978). Mean concentrations of total protein, albumin, IgG and proportional IgG levels in CSF by transudation, exudation and intracranial synthesis were elevated in neurocysticercosis. But only the intracranial synthesis of IgG showed a statistically significant correlation with the specific IgG antibody levels in CSF. In CSF from lateral ventricle in the 4th ventricular neurocysticercosis, the protein concentrations were normal and the specific antibody levels were negative. However, in consecutively secured lumbar CSF from the same patients, the former were increased and the latter were positive. These results indicated that, in neurocysticercosis, the specific IgG antibody in CSF was a local product of intracranial synthesis.
parasitology-helminth-cestoda ; Taenia solium ; cysticercus ; enzyme-linked immunosorbent assay ; cerebrospinal fluid ; brain ; IgG ; immunology

Recently reports on toxocariasis are increasing by serodiagnosis in Korea. A previously healthy 17-yr-old boy complained of headache, fever, dyspnea, and anorexia. He showed symptoms and signs of eosinophilic meningitis with involvement of the lungs and liver. Specific IgG antibody to Toxocara canis larval antigen was positive in serum and cerebrospinal fluid by ELISA. He took raw ostrich liver with his parents 4 weeks before the symptom onset. His parents were seropositive for T. canis antigen but had no symptoms or signs suggesting toxocariasis. This is the first report of toxocariasis in a family due to ingestion of raw ostrich liver in Korea.
Adolescent ; Animals ; Antibodies, Helminth/blood/cerebrospinal fluid ; Eating ; Humans ; Larva/immunology ; Liver/parasitology ; Male ; Meningitis/*diagnosis/parasitology ; Struthioniformes ; Tomography, X-Ray Computed ; Toxocara canis/growth & development/*immunology/isolation & purification ; Toxocariasis/*diagnosis/parasitology/transmission

After bathing at a hot spring resort, a 75-year-old man presented to the emergency department because of seizure-like attack with loss of conscious. This is the first case of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri in Taiwan. PAM was diagnosed based on detection of actively motile trophozoites in cerebrospinal fluid using a wet-mount smear and the Liu's stain. The amoebae were further confirmed by PCR and gene sequencing. In spite of administering amphotericin B treatment, the patient died 25 days later.
Aged ; Amebiasis/*diagnosis/parasitology/*pathology ; Central Nervous System Protozoal Infections/*diagnosis/parasitology/*pathology ; Cerebrospinal Fluid/parasitology ; DNA, Protozoan/chemistry/genetics ; Fatal Outcome ; Humans ; Male ; Microscopy ; Naegleria fowleri/classification/genetics/*isolation & purification ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Taiwan