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. 2024 Jul 1;27(4):443-447.
doi: 10.4103/aian.aian_2_24. Epub 2024 Apr 17.

Cerebral Sparganosis - An Unusual Parasitic Infection Mimicking Cerebral Tuberculosis: Isolation of a Live Plerocercoid Larva of Spirometra mansoni

Abhishek Rathore  1 , Hansashree Padmanabha  1 , Rohan Mahale  1 , Ankit Arora  2 , Aditi Goyal  3 , Jeevika Reddy  1 , Mahak Sipani  4 , Nupur Pruthi  4 , T S Lingaraju  4 , S Nagarathna  5 , T C Yasha  3 , Jitender Saini  2 , Saraswati Nashi  1 , M Pooja  1 , P S Mathuranath  1
Affiliations

Cerebral Sparganosis - An Unusual Parasitic Infection Mimicking Cerebral Tuberculosis: Isolation of a Live Plerocercoid Larva of Spirometra mansoni

Abhishek Rathore et al. Ann Indian Acad Neurol. .
No abstract available

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Initial MRI. (a and b) Axial and coronal T2-weighted images reveal conglomerated heterogeneous signal intensity lesions in the left parietal lobe with internal specks of T2 hypointensity. (c and d) Diffusion-weighted images with corresponding apparent diffusion coefficient (ADC) maps show no obvious diffusion restriction. (e and f) Multiple punctate foci of blooming are seen on Susceptibility weighted imaging (SWI) images, few of which correspond to calcifications on CT. (g) Postcontrast images reveal heterogeneous avid enhancement within the lesion with internal hypoenhancing areas. (h) No significant elevated perfusion is demonstrated within the lesion in the colored relative cerebral blood volume (r CBV) maps. CT = computed tomography, MRI = magnetic resonance imaging
Figure 2
Figure 2
Follow-up MRI after 15 months of ATT. (a and b) Axial and coronal T2-weighted images reveal a new similar lesion in the left temporal lobe, which is heterogeneous in signal intensity with surrounding vasogenic edema. (c and d) Axial diffusion-weighted images with ADC maps show mild reduced diffusivity within the lesion. (e and f) Lesion in the left temporal lobe shows irregular heterogeneous enhancement with internal hypoenhancing areas, whereas the lesion in the left parietal lobe is significantly decreased in size with few persisting nodular enhancing areas (white arrowhead in e). (g and h) T2-weighted and CT images showing the lesion in the left parietal lobe has significantly decreased in size with thinning of cortex and punctate calcific foci. ATT = antitubercular treatment, CT = computed tomography, MRI = magnetic resonance imaging
Figure 3
Figure 3
Microphotograph of the H and E-stained section showing histopathology of the bladder wall of the cestode larva (a), with the outermost dense eosinophilic tegument (arrow), tegumental cells beneath it with small nuclei, and smooth muscle merging into loose parenchyma (b) with excretory channels (“*”) which are dilated (inset, b). The smooth muscle is oriented longitudinally (c). The head of the larva shown in (d) does not contain suckers or hooklets. (magnification = scale bar [20 µm]). H and E = hematoxylin and eosin
Figure 4
Figure 4
Follow-up MRI 4 months postoperatively. (a and b) Axial and coronal T2-weighted images demonstrate cortical thinning and atrophy in the left parietal and temporal lobes, inferring gliosis. (c and d) Axial and trace maps of diffusion-weighted imaging show no evident diffusion restriction in the involved areas. (e and f) Susceptibility-weighted images show linear foci of blooming along the gyri in the left parietal and temporal lobes. (g and h) Few punctate enhancing areas are noted in the left parietal and temporal lobes. Also evident are postoperative changes along the left calvaria and the left temporal lobe (white arrowheads). MRI = magnetic resonance imaging
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