CHRONIC CEREBRAL PARAGONIMIASIS COMBINED WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE

JUK-DONG CHOO 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

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BUMN-SUK SUH 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

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HYUN-SUNG 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

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JONG-SOO 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

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CHANG-JUNE SONG 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

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DAE-WHAN SHIN 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

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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

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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.

Author Notes

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@cnu.ac.kr.
  • 1

    Bunnay D, Cross JH, Bunnay T, 2000. Lung fluke infections; paragonimiasis. Strickland GT, ed. Hunter’s Tropical Medicine and Eemerging Infectious Diseases. Eighth edition. Philadelphia: W. B. Saunders Company, 847–851.

  • 2

    Cho SY, 1994. Epidemiology of paragonimiasis in Korea. Chai JY, Cho SY. Han IS, Lee SH, Rim HJ, eds. Collected Papers on Parasite Control in Korea. Seoul, Korea: The Korea Association of Health, 51–57.

  • 3

    Chang KH, Cha SH, Han MH, Kim HD, Cho SY, Kong Y, Kang HK, Kim MS, 1993. An imaging diagnosis of cerebral paragonimiasis: CT and MR findings and correlation with ELISA antibody test. J Korean Radiol Soc 29 :345–354.

    • Search Google Scholar
    • Export Citation
  • 4

    Cha SH, Chang KH, Cho SY, Han MH, Kong Y, Suh DC, Choi CG, Kang HK, Kim MS, 1994. Cerebral paragonimiasis in early active stage: CT and MR features. AJR Am J Roentgenol 162 :141–145.

    • Search Google Scholar
    • Export Citation
  • 5

    Catapano MS, Marx JA, 1986. Central nervous system cysticercosis simulating an acute cerebellar hemorrhage. Ann Emerg Med 5 :847–849.

  • 6

    Jeong SC, Bae JC, Hwang SH, Kim HC, Lee BC, 1998. Cerebral sparganosis with intracerebral hemorrhage: a case report. Neurology 50 :503–506.

    • Search Google Scholar
    • Export Citation
  • 7

    Berlit P, Popescu O, Weng Y, Malessa R, 1996. Disseminated cerebral hemorrhages as unusual manifestation of toxoplasmic encephalitis in AIDS. J Neurol Sci 143 :187–189.

    • Search Google Scholar
    • Export Citation
  • 8

    Gall C, Spuler A, Fraunberger P, 1999. Subarachnoid hemorrhage in a patient with cerebral malaria. N Engl J Med 341 :611–613.

  • 9

    Brenes Madrigal R, Rodriguez-Ortiz B, Vargas Solano G, Ocamp Obando EM, Ruiz Sotela PJ, 1982. Cerebral hemorrhagic lesions produced by Paragonimus mexicanus. Report of three cases in Costa Rica. Am J Trop Med Hyg 31 :522–526.

    • Search Google Scholar
    • Export Citation
  • 10

    Hara K, Yamasaki M, Okuda B, Maya K, Imai T, 1985. A case of cerebral paragonimiasis with intracerebral hemorrhage as initial finding. Rinsho Shinkeigaku 25 :808–811.

    • Search Google Scholar
    • Export Citation
  • 11

    Beers MH, Berkow R, 2002. The Merck Manual of Diagnosis and Therapy. 17th edition. Rahway, NJ: Merck Research Laboratories.

  • 12

    Oh SJ, 1969. The rate of cerebral involvement in paragonimiasis: an epidemiologic study. Jpn J Parasitol 18 :211–214.

  • 13

    Yin CY, Shin YZ, 2002. Investigation of inpatient cases of food-borne parasitic encephalopathy. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 20 :177–179.

    • Search Google Scholar
    • Export Citation
  • 14

    Kadota T, Ishikura R, Tabuchi Y, Nakao N, Fujikawa H, Kaba K, Tani E, Miura T, 1989. MR imaging of chronic cerebral paragonimiasis. AJNR Am J Neuroradiol 10 :S21–S22.

    • Search Google Scholar
    • Export Citation
  • 15

    Nomura M, Nitta H, Nakada M, Yamashima T, Yamashita J, 1999. MRI findings of cerebral paragonimiasis in chronic stage. Clin Radiol 54 :622–624.

    • Search Google Scholar
    • Export Citation
  • 16

    Kang SY, Kim TK, Kim TY, Ha YI, Choi SW, Hong SJ, 2000. A case of chronic cerebral paragonimiasis westermani. Korean J Parasitol 38 :167–171.

    • Search Google Scholar
    • Export Citation
  • 17

    Sasaki M, Kamiyama T, Yano T, Nakamura-Uchiyama F, Nawa Y, 2002. Active hepatic capsulitis caused by Paragonimus westermani infection. Intern Med 41 :661–663.

    • Search Google Scholar
    • Export Citation
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