Long-term albendazole therapy for diffuse parenchymal neurocysticercosis in an immunocompetent patient: A case report

Abstract

Rationale: Neurocysticercosis is a neglected tropical disease caused by the larvae of Taenia solium and may occur in immunocompetent people. We report a case of diffuse parenchymal neurocysticercosis mimicking tuberculous meningitis in an immunocompetent patient. Patient concerns: A 24-year-old immunocompetent woman presented with serial focal to generalized seizure, left body weakness, left abducens palsy, chronic cough, and body weight loss. She came from an area where she was unlikely to have contact with Taenia solium. Diagnosis: Diffuse parenchymal neurocysticercosis. Intervention: Valproic acid, dexamethasone and 15 months of albendazole therapy. Outcome: Complete recovery without any neurological sequelae. Lessons: Prolonged anthelminthic treatment may benefit neurocysticercosis patients with multiple cerebral parenchymal lesions.

Keywords

Albendazole / Corticosteroid / Neurocysticercosis / Prognosis / Taenia solium / Tuberculous meningitis

References

[1] Bizhani N, Hashemi SH, Mohammadi N, Rezaei M, Rokni MB. Human cysticercosis in Asia: A systematic review and meta-analysis. Iran J Public Health 2020; 49(10):1839-1847.

[2] Jaime F, Randy GO, Sandra PC, Javier MF, Liliana M, Alfonso TC, et al. Long-term follow-up of patients with neurocysticercosis and the development of seizures. J Transl Sci 2016; 1(2):49-54.

[3] Butala C, Brook TM, Majekodunmi AO, Welburn SC. Neurocysticercosis: Current perspectives on diagnosis and management. Front Vet Sci 2021; 8(5):1-10.

[4] Garcia HH, Nash TE, Del Brutto OH. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 2014; 13(12):1202-1215.

[5] Bintari DC, Ardiansyah D, Sugianto P. Mycobacterium tuberculosis infection in the central nervous system mimicking metastatic process. Ann Rom Soc Cell Biol 2021; 25(6):20360-20365.

[6] Cupertino M, Resende M, Mayer N, Carvalho L, Siqueira-Batista R. Emerging and re-emerging human infectious diseases: A systematic review of the role of wild animals with a focus on public health impact. Asian Pac J Trop Med 2020; 13(3):99.

[7] Garg R, Kumar N, Rizvi I, Malhotra H. Disseminated cysticercosis presenting with bilateral proptosis: A case report. Asian Pac J Trop Med 2019; 12(7):337.

[8] Pandey S, Malhotra HS, Garg RK, Malhotra KP, Kumar N, Rizvi I, et al. Quantitative assessment of lesion load and efficacy of 3 cycles of albendazole in disseminated cysticercosis: A prospective evaluation. BMC Infect Dis 2020; 20(1):220.

[9] Carpio A, Romo ML, Hauser WA, Kelvin EA. New understanding about the relationship among neurocysticercosis, seizures, and epilepsy. Seizure 2021; 90:123-129.

[10] Yuzawa H, Hirose Y, Kimura T, Kimura S, Sugawara K, Yanagisawa A, et al. A case of cerebral tuberculoma mimicking neurocysticercosis. Acute Med Surg 2017; 4(3):329-333.