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Am. J. Trop. Med. Hyg., 72(5), 2005, pp. 513-517
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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CASE REPORT


HUMAN BRAIN ABSCESS DUE TO A TETRA-ACETABULATE PLEROCERCOID METACESTODE (CYCLOPHYLLIDEA)

YVES J. F. GARIN, MARIA-TERESA GALÁN-PUCHADES, ANTOINE MOULIGNIER, GILLES ROBERT, FRANÇOISE HÉRAN, MARC POLIVKA, PETE D. OLSON, FRÉDÉRIC LORENZO, FRANCIS DEROUIN, AND DAVID BRUCE CONN
Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, U.F.R. Lariboisière, Université Paris VII, France; Department of Parasitology, Faculty of Pharmacy, University of Valencia, Spain; Service de Neurologie, Service de Neuro-chirurgie, and Service de Radiologie, Fondation Rothschild, Paris, France; Service d’Anatomie et Cytologie Pathologiques, Hôpital Lariboisière, U.F.R. Lariboisière, Université Paris VII, France; Department of Zoology, The National History Museum, London, UK; Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, U.F.R. Lariboisière, Université Paris VII, France; Department of Biology, Berry College, Mount Berry, Georgia

 

ABSTRACT

A 38-year-old man living near Phnom Penh (Cambodia) was admitted to a hospital in Paris in June 2001 for a single episode of a generalized grand mal seizure. This episode was preceded by a 9-month history of headaches. Magnetic resonance imaging (MRI) of the head revealed a rounded lesion immediately ahead of the left central sulcus. The resected lesion was about 20 mm in diameter. Histologic examination revealed an elongated but unsegmented metacestode at the center of the lesion. Polymerase chain reaction (PCR) analysis was inconclusive due to formalin-based histologic processing of the tissue. Morphologic analysis based on the histologic sections revealed that the metacestode was a tetra-acetabulate plerocercoid of the order Cyclophyllidea, with a distinct rostellum and pseudosegmentation of the dorsoventrally flattened hindbody. This is the first report of a tetra-acetabulate plerocercoid from a human host and the first report of any cyclophyllidean plerocercoid from the human brain. After 6 weeks, the patient was asymptomatic, neurologic examination was normal, and the brain MRI showed only surgical cavitation. The patient returned to Cambodia.

Received May 20, 2004. Accepted for publication September 13, 2004.

Acknowledgments: We are indebted to Dr. L. R. Ash, Department of Epidemiology, School of Medecine, University of California, Los Angeles, CA, Pr. J. Euzéby, Parasitology Laboratory, Veterinary School, Lyon, France, Pr. L. Euzet, Station Mediterranéenne de l’Environnement Littoral, UMR CNRS 555, Sète, France, and Dr. K. S. Eom, Department of Parasitology, College of Medicine, Chungbuk National University, Cheongju, Korea, for their assistance to diagnosis.

Financial support: Pete D. Olson was supported by a Wellcome Trust Senior Fellowships (043965/Z/95/Z) to DTJ Littlewood.

Authors’ addresses: Yves J. F. Garin and Francis Derouin, Laboratoire de Parasitologie-Mycologie, Université Paris VII, 15 rue de l’Ecole de Médecine, 75006, Paris, France, Telephone: 33-14-329-6525, Fax: 33-14-329-5192, E-mail: jfgarin{at}bhdc.jussieu.fr. Maria Teresa Galán-Puchades, Department of Parasitology, Faculty of Pharmacy, University of València, Av. Vicent Andrés Estellès s/n, 46100 Burjassot-València, Spain. Antoine Moulignier, Gilles Robert, Françoise Héran, Service de Neurologie, Service de Neuro-chirurgie, and Service de Radiologie (respectively), Fondation Ophtalmologique de Rothschild, 25–29 rue Manin, 75019 Paris, France. Marc Polivka, Service Central d’Anatomie et Cytologie pathologiques, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France. Peter D. Olson, Wolfson-Wellcome Biomedical Laboratories, Department of Zoology, Parasitic Worm Division, The National History Museum, Cromwell Road, London SW7 5BD, UK. Frédéric Lorenzo, Finoxsil, 1 square Gutemberg, 2123 Boulevard d’Auteuil, 92100 Boulogne-Billancourt, France. David Bruce Conn, Department of Biology, Berry College, Mount Berry, GA 30149.

Reprint requests: Yves J. L. Garin, Laboratoire de Parasitologic-Mycologie, 15 rue de l’Ecole de Médecine, 75006, Paris, France.






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