Citation Information :
Ponnambath DK, Kaviyil JE, Raja K, Kesavapisharady K, Thomas B, Narasimhaiah D, Sehgal R, Kaur U. An unusual guest in an unusual location of the brain of a rural tribal man. 2022; 24 (1):44-47.
We report a rare occurrence of central nervous system hydatid disease involving the occipital lobe caused by Echinococcus multilocularis in an immunocompetent rural tribal man. A 40-year-old man presented with gradual onset of headache for 6-month duration with associated seizures and giddiness. Neurological examination revealed cerebellar signs with visual field defect. Magnetic resonance imaging revealed a multilobulated cystic lesion with membranous septations and peri-lesional oedema involving the left occipital lobe. Wet mount examination of the aspirated cystic fluid showed multiple daughter cysts and hooklets with histopathological examination showing features suggestive of hydatid disease. The identification of the causative organism was confirmed as E. multilocularis by conventional polymerase chain reaction. The patient's condition improved during the post-operative period and was discharged 2 days later, on oral albendazole for 3 months. At 2 years follow-up, the patient neurological symptoms have recovered with minimal visual field defect.
Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020.
Georges S, Villard O, Filisetti D, Mathis A, Marcellin L, Hansmann Y, et al. Usefulness of PCR analysis for diagnosis of alveolar echinococcosis with unusual localizations: Two case studies. J Clin Microbiol 2004;42:5954-6.
Dinkel A, von Nickisch-Rosenegk M, Bilger B, Merli M, Lucius R, Romig T. Detection of Echinococcus multilocularis in the definitive host: Coprodiagnosis by PCR as an alternative to necropsy. J Clin Microbiol 1998;36:1871-6.
Stieger C, Hegglin D, Schwarzenbach G, Mathis A, Deplazes P. Spatial and temporal aspects of urban transmission of Echinococcus multilocularis. Parasitology 2002;124:631-40.
WHO. World Health Organisation (WHO) Fact Sheet on Echinococcosis; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/echinococcosis. [Last accessed on 2022 Apr 04].
Baldolli A, Bonhomme J, Yera H, Grenouillet F, Chapon F, Barbier C, et al. Isolated cerebral alveolar echinococcosis. Open Forum Infect Dis 2019;6:ofy349.
Reuss AM, Wulf MA, Oertel MF, Bozinov O, Henzi A, Kaelin MB, et al. An immunocompetent farmer with isolated cerebral alveolar echinococcosis: Illustrative case. J Neurosurg Case Lessons 2021;1:CASE2187. Available from: https://thejns.org/view/journals/j-neurosurg-case-lessons/1/22/article-CASE2187.xml. [Last accessed on 2022 Apr 07].
Du G, Li Y, Wu P, Wang X, Su R, Fan Y, et al. Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis. Chin Neurosurg J 2021;7:30.
Kemaloğlu S, Ozkan U, Bükte Y, Acar M, Ceviz A. Growth rate of cerebral hydatid cyst, with a review of the literature. Childs Nerv Syst 2001;17:743-5.
Li S, Chen J, He Y, Deng Y, Chen J, Fang W, et al. Clinical features, radiological characteristics, and outcomes of patients with intracranial alveolar echinococcosis: A case series from Tibetan areas of Sichuan Province, China. Front Neurol 2020;11:537565.
Kantarci M, Bayraktutan U, Karabulut N, Aydinli B, Ogul H, Yuce I, et al. Alveolar echinococcosis: Spectrum of findings at cross-sectional imaging. Radiographics 2012;32:2053-70.