Thread by @guerreroespejo

A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.

Blood eosinophil count of 890/μL.

MRI: a brain cyst.
1/8

DOI: doi.org/10.4269/ajtmh.…
#neurology #pediatric #MedTwitter

Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖

The brain cyst was fully removed surgically.
2/8

DOI: doi.org/10.4269/ajtmh.…
#neuro #Pediatrics #surgery

Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.

Over the following 4 months, he was treated with albendazole without complications.
3/8

#parasitology #microbiology #IDtwitter

Sequential imaging showed considerable improvement: CT (A) pre surgery; (B) day 1, post-surgery; (C) 2 months post-surgery. (D) Brain MRI 4 months post-surgery.

There were no residual neurologic deficits on follow-up examination.
4/8

#radiology #radiologist #radres #radiologia

Echinococcus granulosus is:
📌 a tapeworm that causes zoonotic infection (echinococcosis or hydatid disease) and
📌transferred to humans, the intermediate hosts of the worm, by ingestion of contaminated food with the parasite’s eggs.
5/8

#parasites #MedStudentTwitter

Echinococcosis is endemic in southern Israel, especially in the Bedouin population, likely because of close daily contact between humans and animals, particularly stray dogs, the definitive host of E. granulosus.
6/8

DOI: doi.org/10.4269/ajtmh.…
#medicine #Doctor #MedEd

Humans develop cystic (larval) disease, mainly of the liver or the lungs, over long periods.

Hydatid brain cyst is relatively rare (less than 2% of hydatidosis cases).
7/8

#Neurología #resident

Diagnosis requires:
✔️ a high index of suspicion,
✔️ typical radiographic findings, and
✔️ specific serology test, which has low sensitivity in extra-hepatic cases
8/8

#MedicalStudents #pediatria #microbiology