Cerebral Hemorrhagic Lesions Produced by Paragonimus Mexicanus

Report of Three Cases in Costa Rica

Rodrigo Brenes MadrigalDepartamento de Parasitología, Facultad de Microbiología, and Servicio de Patología, Hospital Nacional de Niños, Universidad de Costa Rica, and Servicío de Patología, Hospital Monseñor Sanabria, Puntarenas, Costa Rica

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Beatriz Rodríguez-OrtizDepartamento de Parasitología, Facultad de Microbiología, and Servicio de Patología, Hospital Nacional de Niños, Universidad de Costa Rica, and Servicío de Patología, Hospital Monseñor Sanabria, Puntarenas, Costa Rica

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Gilberto Vargas SolanoDepartamento de Parasitología, Facultad de Microbiología, and Servicio de Patología, Hospital Nacional de Niños, Universidad de Costa Rica, and Servicío de Patología, Hospital Monseñor Sanabria, Puntarenas, Costa Rica

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Eduardo Monge Ocampo ObandoDepartamento de Parasitología, Facultad de Microbiología, and Servicio de Patología, Hospital Nacional de Niños, Universidad de Costa Rica, and Servicío de Patología, Hospital Monseñor Sanabria, Puntarenas, Costa Rica

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Pedro J. Ruiz SotelaDepartamento de Parasitología, Facultad de Microbiología, and Servicio de Patología, Hospital Nacional de Niños, Universidad de Costa Rica, and Servicío de Patología, Hospital Monseñor Sanabria, Puntarenas, Costa Rica

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Three cases of cerebral lesions due to Paragonimus mexicanus in Costa Rica are reported, two of which were fatal. At autopsy a hemorrhagic, well circumscribed lesion was found in the hemispheres which microscopically consisted of a recent hemorrhage surrounded by a halo of eosinophils, with giant cell granulomas and Charcot-Leyden crystals. Eggs of P. mexicanus outside the brain were demonstrated in both fatal cases—in an eosinophilic pericarditis in one and in the other in multiple lesions of the liver and lungs. The third patient had a hemorrhagic cerebral lesion which was surgically evacuated; the patient recovered. Eggs were demonstrated in serial sections of the material resected.

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