Poudel Bipin, Shrestha Shubham, Bhattarai Bishuddha, Khatri Bishal, Acharya Anusha, Maharjan Bunu, Pandey Rabindra R, Batajoo Ashim, Khadka Kishor, Thapa Suman, Koirala Janak
Department of Internal Medicine, Patan Academy of Health Sciences, Lalitpur.
Department of Internal Medicine, HAMS Hospital, Kathmandu.
Ann Med Surg (Lond). 2023 Sep 13;85(11):5704-5708. doi: 10.1097/MS9.0000000000001292. eCollection 2023 Nov.
Cysticercosis is a condition in which humans are infected by the larval form of the pork tapeworm . Cysticercosis in humans is common in the cerebral tissue but rare in the tongue.
Here, the authors report a rare case of a 38-year-old male with neurocysticercosis and cysticercosis of the tongue. The patient presented with a complaint of loss of consciousness for 4-5 min. Local examination of his oral cavity revealed a swelling of ~2×2 cm on the tongue. An MRI of the brain showed various stages of neurocysticercosis involving the neuroparenchyma and tongue. For this, he was started on low-dose prednisolone of 50 mg tapered over 6 weeks and levetiracetam of 500 mg BD continued for his seizure episodes. He is responding well with the medications and is planned to start antiparasitic agent only after the perilesional edema decreases.
Cysticercosis may involve the central nervous system, muscle, heart, lungs, peritoneum, eye, and subcutaneous tissue. Oral cavity and perioral involvement by cysticercous larva is rare in humans. Radiologic imaging, serology, and tissue biopsy can be used to confirm a diagnosis of cysticercosis. The most common locations for oral cysticercosis are the tongue, buccal mucosa, lower lip, and upper lip.Only 102 cases of oral cysticercosis have been reported based on a PubMed English-language literature search.
Oral cysticercosis is a rare event, and it represents a difficulty in clinical diagnosis. But a patient with a mass in the tongue should be considered as a possible case of cysticercosis especially in endemic regions like Nepal.
囊尾蚴病是一种人类因感染猪带绦虫幼虫而引发的疾病。人类囊尾蚴病在脑组织中较为常见,但在舌部却很罕见。
在此,作者报告了一例罕见病例,一名38岁男性患有神经囊尾蚴病和舌部囊尾蚴病。患者因意识丧失4 - 5分钟前来就诊。口腔局部检查发现舌部有一个约2×2厘米的肿胀。脑部磁共振成像(MRI)显示神经囊尾蚴病处于不同阶段,累及神经实质和舌部。为此,开始给予患者低剂量泼尼松龙,50毫克,在6周内逐渐减量,同时继续给予左乙拉西坦,500毫克,每日两次,用于控制癫痫发作。患者对药物反应良好,计划在病灶周围水肿减轻后仅开始使用抗寄生虫药物。
囊尾蚴病可能累及中枢神经系统、肌肉、心脏、肺、腹膜、眼睛和皮下组织。人类中囊尾蚴幼虫累及口腔和口周区域的情况罕见。放射影像学、血清学和组织活检可用于确诊囊尾蚴病。口腔囊尾蚴病最常见的部位是舌部、颊黏膜、下唇和上唇。基于PubMed英文文献检索,仅报告了102例口腔囊尾蚴病病例。
口腔囊尾蚴病是一种罕见情况,在临床诊断中存在困难。但对于舌部有肿物的患者,尤其是在尼泊尔等流行地区,应考虑可能为囊尾蚴病病例。