Thinking Outside Malaria: A Rare Case of Disseminated Cysticercosis With Cardiopulmonary Involvement From Urban Tanzania

Abstract

Dissemination of the cysticerci throughout the body with cardiopulmonary involvement represents a very rare occurrence and an uncommon form of cysticercosis manifestation. We report a rare case of a 48-year-old African male from urban Tanzania who was, at first, referred to our radiology department for a coronary computed tomography angiography (CCTA), but incidentally on further evaluation of the patient revealed a history of recurrent convulsions, loss of consciousness, a single episode of temporary loss of vision and recent skin nodules. The value of a full clinical and radiological evaluation of the patient presenting with adult-onset seizures cannot be overemphasized for the diagnosis of this disease. Management of disseminated cysticercosis is complex and, therefore, should be tailored to fit the individual cases and focus on clinical manifestations.

Keywords: brain mass; cardiopulmonary cysticercosis; cysticercosis; epilepsy; seizure; taenia solium.

Figure 1. Photograph showing a subcutaneous skin nodule on the left side of the neck, which is circled red.

Figure 2. Axial IV contrasted brain CT showing (A) numerous cystic hypodense lesions pointed by short arrows, and (B) fewer calcified cystic lesion six weeks after treatment, some with a dot sign pointed by long arrows.

Figure 3. Cardiac CT images on the left side (A, C) showing multiple hypodense cystic lesions pointed with curved arrows at the interventricular septum and papillary muscles before treatment, and on the right side (B, D), significantly smaller and fainter lesions pointed with long arrows six weeks after treatment.

Figure 4. Chest CT images on the left side (A, C) showing nodular lesions pointed with arrows with tails before treatment, and on the right side (B, D), the same lesions pointed with arrowheads but reduced in size six weeks after treatment.

Figure 5. Axial IV contrasted images showing cysticerci as hypodense lesions involving the (A) head, (B) chest, (C) abdomen, and (D) pelvic muscles, which have been circled.