Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar, Pradesh-226014, India.
Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar, Pradesh-226014, India.
Eur J Clin Microbiol Infect Dis. 2022 Nov;41(11):1361-1364. doi: 10.1007/s10096-022-04498-1. Epub 2022 Sep 22.
We report a patient with racemose neurocysticercosis, highlighting the diagnostic and management issues. A 37-year-old male had headaches, fever, and seizures for 8 months. He had a positive tuberculin test, cerebrospinal fluid pleocytosis, and hydrocephalus and exudates on MRI. His symptoms rapidly resolved following antitubercular and prednisolone treatment. After 2 months, he was readmitted with headache and vomiting, and his brain MRI revealed communicating hydrocephalus with a cyst in the lateral ventricle and subarachnoid space, which was confirmed as neurocysticercosis on the third ventriculostomy. The patient was managed with dexamethasone and a ventriculoperitoneal shunt. This case highlights that meningitis symptoms, CSF pleocytosis, and positive tuberculin tests may not always suggest tubercular etiology.
我们报告了 1 例脑囊尾蚴病患者，重点介绍了其诊断和治疗问题。患者男，37 岁，头痛、发热、抽搐 8 个月。结核菌素试验阳性，脑脊液白细胞增多，MRI 显示脑积水和渗出。抗结核和泼尼松龙治疗后症状迅速缓解。2 个月后，患者因头痛和呕吐再次入院，脑 MRI 显示交通性脑积水，侧脑室和蛛网膜下腔有囊肿，第三次脑室造瘘术后证实为脑囊尾蚴病。患者接受地塞米松和脑室-腹腔分流术治疗。该病例提示，脑膜炎症状、CSF 白细胞增多和结核菌素试验阳性并不总是提示结核病因。
