Three cases of imported neurocysticercosis in Northern Italy

J Travel Med. 2014 Jan-Feb;21(1):17-23. doi: 10.1111/jtm.12066. Epub 2013 Sep 10.

Abstract

Background: Neurocysticercosis (NCC) is an important cause of adult-onset seizures in endemic areas, whereas it is emerging in some nonendemic areas as well because of extensive immigration.

Method: We describe three cases of imported NCC recently admitted to San Bortolo Hospital in Vicenza, located in Northern Italy.

Results: All patients were immigrants. One patient was human immunodeficiency virus positive with severe immunosuppression. The diagnosis of NCC was made on the basis of magnetic resonance results; failure of anti-Toxoplasma, antitubercular, and antifungal therapy; and regression of the cystic lesions after empiric therapy with albendazole. Serology was positive in only one case. In one patient, NCC was diagnosed by biopsy of the brain lesion.

Conclusion: In nonendemic countries, NCC should be included in the differential diagnosis of all patients coming from endemic areas with seizures, hydrocephalus, and compatible lesions on brain imaging. Long-term follow-up is required but may be difficult to implement because these patients tend to move in search of employment. Screening of patient's household contacts for Taenia solium infection should always be carried out.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Albendazole / administration & dosage*
  • Animals
  • Anticestodal Agents / administration & dosage
  • Brain / pathology*
  • Diagnosis, Differential
  • Emigrants and Immigrants
  • Female
  • Humans
  • Hydrocephalus* / diagnosis
  • Hydrocephalus* / etiology
  • Italy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurocysticercosis* / blood
  • Neurocysticercosis* / diagnosis
  • Neurocysticercosis* / drug therapy
  • Neurocysticercosis* / etiology
  • Neurocysticercosis* / physiopathology
  • Seizures* / diagnosis
  • Seizures* / etiology
  • Serologic Tests / methods
  • Taenia solium / isolation & purification*
  • Tomography, X-Ray Computed
  • Travel
  • Treatment Outcome

Substances

  • Anticestodal Agents
  • Albendazole