A Case of Lagochilascariasis in Suriname with the Involvement of the ENT System and the Skull Base

Joeri A. J. Douma VU University Medical Center, Amsterdam, The Netherlands.

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Ralph A. E. Akrum Academic Hospital Paramaribo, Paramaribo, Suriname.

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Rudie Tjong Tjin Joe Academic Hospital Paramaribo, Paramaribo, Suriname.

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Mike Chan Academic Hospital Paramaribo, Paramaribo, Suriname.

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John Codrington Academic Hospital Paramaribo, Paramaribo, Suriname.

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Stephen Gerold S. Vreden Academic Hospital Paramaribo, Paramaribo, Suriname.

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We describe a case of human lagochilascariasis, with skull-base involvement and a chronic and relapsing course after treatment. This rare parasitic infection is usually manifested in the head and neck area, characterized by progressive granulomatous inflammation and the formation of abscesses. Transmission to humans most likely occurs by the consumption of undercooked meat of wild rodents. On the basis of literature studies, we propose the most likely life cycle of the parasite that involves wild feline and rodent species, with humans as accidental hosts. Even in endemic areas, it is very difficult to recognize the disease at an early stage. Progression will eventually lead to involvement of the (central) nervous system, as described in our case. Treatment is often difficult and involves resection and prolonged treatment with anthelmintic drugs. Recurrences are not uncommon and at present, long-term oral administration of ivermectin seems to be the most effective treatment.

Author Notes

* Address correspondence to Joeri A. J. Douma, VU University Medical Center, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands. E-mail: joeridouma@gmail.com

Authors' addresses: Joeri A. J. Douma, Department of Internal medicine, VU University Medical Center, Amsterdam, The Netherlands, E-mail: joeridouma@gmail.com. Ralph A. E. Akrum, Department of Ear, Nose, and Throat, Academic Hospital Paramaribo, Paramaribo, Suriname, E-mail: raeakrum@hotmail.com. Rudie Tjong Tjin Joe, Department of Neurosurgery, Academic Hospital Paramaribo, Paramaribo, Suriname, E-mail: rtjongtjinjoe@azp.sr. Mike Chan, Department of Pathology, Academic Hospital Paramaribo, Paramaribo, Suriname, E-mail: mchan@azp.sr. John Codrington, Department of Clinical Chemistry, Academic Hospital Paramaribo, Paramaribo, Suriname, E-mail: johncodrington@hotmail.com. Stephen Gerold S. Vreden, Department of Internal Medicine, Academic Hospital Paramaribo, Paramaribo, Suriname, E-mail: stephenvreden@yahoo.com.

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