Disseminated cysticercosis with a right common femoral vein thrombosis

Abstract

Disseminated cysticercosis is an uncommon presentation of cysticercosis. Less than 10 cases of disseminated cysticercosis have been reported worldwide in children. We report the case of an 8-year-old boy with disseminated cysticercosis, who had presented with a swelling of the body for 1 month and proptosis of the eyeballs for 14 days. On examination, he had bilateral proptosis, subcutaneous nodules and hypertrophy of muscles of the limbs, neck and face. The CT cranium was normal, but the orbit showed bilateral bulky extraocular muscles heterogeneous in their whole length. The MRI cranium and whole body showed multiple non-enhancing vesicular cysts involving the brain, extraocular muscle, heart, trunk and muscles of the extremities and subcutaneous tissues. A Doppler study of the femoral vein showed thrombosis of the right common femoral vein. He was managed with corticosteroid, albendazole, phenytoin sodium, low-molecular-weight heparin followed by warfarin for 6 months and recovered completely.

Figure 1

Patient's photograph showing the proptosis of both eyes with hypertrophy of the calf muscles.

Figure 2

Fundal photograph showing an elevated cystic mass over the macula with a central yellowish patch in the left eye.

Figure 3

Ultrasonography of the skeletal muscles showing a honeycomb pattern of densely packed cysts.

Figure 4

A Doppler flow study showing thrombosis of the right common femoral vein.

Figure 5

Cranial CT showing a bilaterally bulky medial and lateral rectus muscle.

Figure 6

(A–D) Serial MRI showing multiple cystic, densely packed subcentimeter lesions in the brain, extraocular muscle, cardiac muscle and skeletal muscles of the face, neck, trunk, and upper and lower limbs.