Immune-inflammatory markers in massively disseminated cysticercosis

Abstract

Disseminated cysticercosis is a common endemic tropical infection. We report a 24-year-old man who presented with a single episode of focal seizure and transient depression. Imaging studies revealed disseminated vesicular cysticercosis involving almost all the body parts. In spite of severe dissemination and significantly raised immunological inflammatory markers, the patient had negligible symptoms. He was subsequently followed up with oral corticosteroid and antiepileptic drug without further complication. The extensive dissemination, relatively benign nature of the disease and clinicoradiological discordance are interesting to describe. This neglected tropical infection can sometimes be alarming and needs public health awareness.

Figure 1

(A) MRI of the brain with T2 axial sequence showing innumerable intraparenchymal and extraparenchymal vesicular cysts containing clear fluid and scolices (arrow). (B) T2 sagittal section showing infiltration of cysts in the orbital, extraocular, neck and tongue muscles.

Figure 2

(A and B) MRI of the whole body revealing extensive infestation of organs such as intestines, pancreas, heart, liver, pleura and genitourinary organs.

Figure 3

(A and B) MRI of the skeletal muscles of the shoulder, thorax, trunk, paraspinal and limb muscles showed multiple linear, hyperintense cysticercoids.