A 12-year-old boy who was diagnosed with a cyst containing tapeworm larva in his brain is among the reports published in today’s edition of BMJ Case Reports (13 September, 2016).
The case, reported in Beirut, Lebanon, reveals that the boy was admitted to hospital, having suffered with headaches, projectile vomiting and occasional blurry vision over the previous six months.
It is rare for Echinococcus granulosus, also called hydatid worm, hyper tape-worm or dog tapeworm, to be in the brain. This type of infection – a hydatid cyst – usually involves the liver and lungs, and is endemic in many parts of the world, particularly in the Middle East, Australia, New Zealand, South America and central and south Europe.
Surgery was performed to remove the cyst from the right side of the boy’s brain, and there were no postoperative complications. Scans three months later confirmed no further cysts and the boy made a good recovery.
The publication also describes how a 61-year-old man from the UK developed psittacosis – also known as parrot fever.
The man, a hobbyist bird-keeper, was admitted to hospital with influenza-like symptoms, including fever, cough, malaise and breathlessness. He developed type 2 respiratory failure, became increasingly drowsy, and had convulsions in the intensive care unit.
Although clinicians initially thought he had community-acquired pneumonia and meningoencephalitis, he was tested for Chlamydia psittaci when it emerged that he kept several species of birds, two of which had unexpectedly died after he was admitted to hospital. The man was treated with antibiotics and made a full recovery.
In another case, doctors write about a 42-year-old man with Schistosoma mansoni (parasitic flatworm) infection, which was likely to have been acquired during a trip to Sierra Leone many years previously.
The patient, who is from Sierra Leone, but who had lived in the UK for 15 years, was admitted as an emergency, having suffered for a week with pain on the left side of his abdomen, fever and diarrhoea.
When the left side of his abdomen was examined, it was tender and a mass was suspected. Chest and abdominal X-rays were normal.
When examining the inner lining of the patient’s large intestine, doctors found a mild and patchy inflammation. Biopsy samples revealed a viable schistosome ovum. The patient was given antiparasitic treatment.
A final case report details the case of a 31-year-old French woman, who developed a hookworm infection following a trip to Gabon.
She noticed a rash on her inner left thigh five days after she returned home and it continued to spread. The rash itched but there were no other symptoms.
Human infection, also known as cutaneous larva migrans, occurs when the skin comes into contact with hookworms, which is common when lying or walking on contaminated beaches. The woman was given antiparasite therapy.
Intracranial hydatid cyst: imaging findings of a rare disease. BMJ Case Reports. September 2016. [abstract]
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