Lee Jung-Ju, Kang Kyusik, Lee Woong-Woo, Kim Byung-Kun, Park Jong-Moo, Kwon Ohyun, Cho Soohyun
Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Encephalitis. 2021 Apr;1(2):51-55. doi: 10.47936/encephalitis.2021.00024. Epub 2021 Apr 5.
Adult cerebral larval infections are rare. Humans are infected by contacting soil that contains infectious eggs or by eating undercooked meat. We encountered a patient with cerebral infection who showed recurrent altered mentality with nonconvulsive status epilepticus (NCSE). A 71-year-old male was admitted with complaints of drowsy mentality and abnormal behavior. Magnetic resonance imaging revealed non-enhanced multiple gliosis and calcified lesions. Electroencephalography revealed NCSE, which was cured with valproate. However, he was readmitted because of recurrence of symptoms. On cerebrospinal fluid examination, antibodies were observed. Subsequently, he was treated with albendazole and corticosteroids. Although corticosteroid improved his symptoms, the therapy could not be continued because the patient developed septic shock. This is the first report of cerebral larval infection presenting as delayed encephalopathy and NCSE. In patients with unexplainable progressive encephalopathy, particularly when gliosis or calcified lesions are observed on neuroimaging, cerebral larval infection should be considered and treated promptly.
成人脑幼虫感染较为罕见。人类通过接触含有感染性虫卵的土壤或食用未煮熟的肉类而被感染。我们遇到了一名脑感染患者，该患者表现为反复出现精神状态改变并伴有非惊厥性癫痫持续状态（NCSE）。一名71岁男性因嗜睡和行为异常入院。磁共振成像显示多发无强化的胶质增生和钙化病变。脑电图显示为NCSE，使用丙戊酸盐治愈。然而，他因症状复发再次入院。脑脊液检查发现了抗体。随后，他接受了阿苯达唑和皮质类固醇治疗。尽管皮质类固醇改善了他的症状，但由于患者发生感染性休克，治疗无法继续。这是首例以迟发性脑病和NCSE表现的脑幼虫感染报告。对于患有无法解释的进行性脑病的患者，特别是在神经影像学检查中观察到胶质增生或钙化病变时，应考虑脑幼虫感染并及时进行治疗。
