Tropical Medicine and Infectious Disease (Aug 2024)

Concomitant Parenchymal, Subarachnoid, and Ventricular Neurocysticercosis in Rome, Italy: A Case Report with a 4-Year Follow-Up

  • Maria Letizia Giancola,
  • Shalom Haggiag,
  • Angela Corpolongo,
  • Alessandro Stasolla,
  • Andrea Mariano,
  • Agazio Menniti,
  • Paolo Campioni,
  • Barbara Bartolini,
  • Pierluigi Galizia,
  • Antonella Vulcano,
  • Carla Fontana,
  • Claudio Gasperini,
  • Elise O’Connell,
  • Hector H. Garcia,
  • Theodore E. Nash,
  • Emanuele Nicastri

DOI
https://doi.org/10.3390/tropicalmed9080187
Journal volume & issue
Vol. 9, no. 8
p. 187

Abstract

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Neurocysticercosis (NCC) is caused by the larval stage of Taenia solium. This parasitic disease is endemic in many areas of the world and is emerging in Europe. NCC can affect different brain regions, but simultaneous involvement of the parenchymal, subarachnoid, and ventricular regions is rare. We report the case of a 39-year-old woman from Honduras, resident in Rome for 10 years, who presented to the Emergency Department complaining of headaches, transient hemianopsia, and bilateral papilledema. MRI showed a concomitant parenchymal, subarachnoid, and ventricular involvement in the brain. T. solium IgG antibodies were detected in the blood. The etiological diagnosis of NCC was obtained by identifying T. solium in cerebrospinal fluid using Next Generation Sequencing. Endoscopic neurosurgery with the placement of a ventricular shunt and medical long-term anti-parasitic treatment with a cumulative number of 463 days of albendazole and 80 days of praziquantel were performed. A successful 4-year follow-up is reported. NCC is one of the most common parasitic infections of the human CNS, but it is still a neglected tropical disease and is considered to be an emerging disease in Europe. Its diagnosis and clinical management remain a challenge, especially for European clinicians.

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