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Am. J. Trop. Med. Hyg., 69(5), 2003, pp. 466-469
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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Right arrow Paragonimiasis

CHRONIC CEREBRAL PARAGONIMIASIS COMBINED WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE

JUK-DONG CHOO, BUMN-SUK SUH, HYUN-SUNG LEE, JONG-SOO LEE, CHANG-JUNE SONG, DAE-WHAN SHIN, AND YOUNG-HA LEE
Department of Neurosurgery, Sun General Hospital, Daejeon, Republic of Korea; Department of Diagnostic Radiology, and Department of Parasitology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

A 67-year-old Korean woman attended our hospital complaining of a severe headache. A brain computed tomography scan showed conglomerated, high-density, calcified nodules in the left temporo-occipito-parietal area and high-density subarachnoid hemorrhage in the basal cisterns. Magnetic resonance imaging of the brain shows multiple conglomerated iso- or low-signal intensity round nodules with peripheral rim enhancement. She underwent craniotomies to clip the aneurysm and remove the calcified masses. Paragonimus westermani eggs were identified in the calcified necrotic lesions. Results of parasitic examinations on the sputum and an enzyme-linked immunosorbent assay for P. westermani were all negative. The patient presented with headache and dizziness that had occurred for more than 30 years. She had not eaten freshwater crayfish or crabs. However, she had sometimes prepared raw crabs for several decades. Overall, this case was diagnosed as chronic cerebral paragonimiasis, in which she may have been infected through the contamination of utensils during the preparation of the second intermediate hosts, combined with a cerebral hemorrhage.

Received July 8, 2003. Accepted for publication August 7, 2003.

Authors’ address: Juk-Dong Choo, Bumn-Suk Suh, Hyun-Sung Lee, and Jong-Soo Lee, Department of Neurosurgery, Sun General Hospital, 10-7 Mok-dong, Jung-gu, Daejeon 301-070, Republic of Korea. Chang-June Song, Department of Diagnostic Radiology, College of Medicine, Chungnam National University, 640 Daesa-dong, Jung-gu Daejeon 301-131, Republic of Korea. Dae-Whan Shin and Young-Ha Lee, Department of Parasitology, College of Medicine, Chungnam National University, 6 Munwha-dong, Jung-gu Daejeon 301-131, Republic of Korea.

Reprint requests: Young-Ha Lee, Department of Parasitology, College of Medicine, Chungnam National University, 6 Munhwa-dong, Jung-gu Daejeon 301-131, Republic of Korea, E-mail: yhalee{at}cnu.ac.kr.




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