First Case of Human Cerebral Taenia martis Cysticercosis

Abstract

Taenia martis is a tapeworm affecting mustelids, with rodents serving as intermediate hosts. The larval stage (cysticercus) has been found before only rarely in humans or primates. We hereby describe a case of cerebral T. martis cysticercosis in a French immunocompetent patient, confirmed by DNA analyses of biopsy material.

FIG 1

Axial fluid attenuated inversion recovery (FLAIR) (a and e), axial diffusion (b), apparent diffusion coefficient map (c), and axial T1 spin echo (SE) after gadolinium injection (d). Shown are mild cortical FLAIR and diffusion hypersignal, with mild restriction of the diffusion coefficient in the left temporal lobe (arrow). An arrowhead shows leptomeningeal enhancement after gadolinium administration in the depth of the adjacent sulcus arrowhead. A star indicates white matter subcortical nonspecific hyperintensities.

FIG 2

Sagittal T1 (a), axial T2 spin echo (SE) (b), T2 star-weighted angiography (SWAN) (c), axial (d) and sagittal (e) T1 SE after gadolinium injection, axial diffusion (f), an apparent diffusion coefficient map (g), and a cerebral blood volume map (h). An arrow indicates a left temporal cortical annular enhancing lesion. The border of the lesion is thick and partially spontaneously hyperintense on T1 and hypointense on T2, with T2 SWAN suggesting the presence of hemosiderin or calcium deposits (arrowhead). The contrast enhancement is predominant in the inner part of the border (arrow). The center of the lesion appears hyperintense on diffusion-weighted MRI, with restriction of the diffusion coefficient suggesting thick content (star). In the center of the lesion, there is a small enhancing nodule attached to the border, hypointense on T2 SWAN (circle). The cerebral blood volume is diminished (h). Significant perilesional edema is revealed.

FIG 3

Neighbor-joining tree based on Cox1 sequences, showing the phylogenetic relationships between the Taenia martis isolate from humans and the other tapeworm species. The black triangle refers to the sequence generated by this study, and the GenBank accession numbers of each strain are given in parentheses. The letters a to d in parentheses refer to Taenia martis isolated from humans (a), Myodes glareolus (b), Apodemus sylvaticus (c), and Myodes rufocanus (d), respectively. Bootstrap values of >70% are included to indicate branch support. Neighbor-joining analysis was processed using MEGA V.5.2. software, and the branch support was evaluated by means of a bootstrap test with 1,000 replicates (14).