Advertisement

Neurocritical Care

, Volume 10, Issue 3, pp 344–346 | Cite as

Concurrent Neurocysticercosis and Pulmonary Tuberculosis

  • Chad M. MillerEmail author
  • Paul M. Vespa
PRACTICAL PEARL

Abstract

Objective

We discuss the case of a 24-year-old male with severe racemose neurocysticercosis.

Clinical features

The patient presented from an outside hospital with 4 months duration of intermittent syncope and a dull occipital headache with greatest severity in the morning. He was noted to have left facial numbness and blurred vision confined to his left eye. Magnetic resonance imaging (MRI) discovered multiple grape-like cystic structures throughout the subarachnoid space and frontal parenchyma consistent with neurocysticercosis. Additional testing revealed radiologic and culture evidence of active pulmonary tuberculosis.

Interventions and outcome

The patient was admitted to the neurocritical care unit and begun on IV corticosteroids, albendazole, and 4-drug RIPE therapy. Improvement in headache, facial numbness, and nausea were noted over the course of 1 week. Visual acuity remained impaired; however, no further episodes of syncope or deterioration were noted.

Conclusion

Effective management of severe racemose neurocysticercosis requires appropriate diagnostic considerations, monitoring, and therapeutics well suited to a comprehensive neurocritical care unit.

Keywords

Neurocysticercosis Taenia solium Cysticercosis Mycobacterium tuberculosis 

References

  1. 1.
    Wallin MT, Kurzke JF. Neurocysticercosis in the United States: a review of an important emerging infection. Neurology. 2004;64(8):1559–64.Google Scholar
  2. 2.
    Hawk MW, Shahlaie K, Kim KD, Theis JH. Neurocysticercosis: a review. Surg Neurol. 2005;63:123–32. doi: 10.1016/j.surneu.2004.02.033.PubMedCrossRefGoogle Scholar
  3. 3.
    Del Brutto OH, Rajshekhar V, White AC Jr, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology. 2001;57:177–83.PubMedGoogle Scholar
  4. 4.
    Sako Y, Ito A. Recent advances in serodiagnosis for cysticercosis. Southeast Asian J Trop Med Public Health. 2001;32:98–104.PubMedGoogle Scholar
  5. 5.
    Garcia HH, Evans CA, Nash TE, et al. Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev. 2002;15:747–56. doi: 10.1128/CMR.15.4.747-756.2002.PubMedCrossRefGoogle Scholar
  6. 6.
    Cosgrove CA, Castello-Branco LR, Hussell T, et al. Boosting of cellular immunity against Mycobacterium tuberculosis and modulation of skin cytokine responses in healthy human volunteers by Mycobacterium bovis BCG substrain Moreau Rio de Janeiro oral vaccine. Infect Immun. 2006;74(4):2449–52. doi: 10.1128/IAI.74.4.2449-2452.2006
  7. 7.
    Chavarria A, Fleury A, Bobes RJ, Morales J, Fragoso G, Sciutto E. A depressed peripheral cellular immune response is related to symptomatic neurocysticercosis. Microbes Infect. 2006;8:1082–9. doi: 10.1016/j.micinf.2005.11.005.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2008

Authors and Affiliations

  1. 1.Ronald Reagan UCLA Medical CenterLos AngelesUSA

Personalised recommendations