Concurrent Neurocysticercosis and Pulmonary Tuberculosis
- 92 Downloads
We discuss the case of a 24-year-old male with severe racemose neurocysticercosis.
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.
Effective management of severe racemose neurocysticercosis requires appropriate diagnostic considerations, monitoring, and therapeutics well suited to a comprehensive neurocritical care unit.
KeywordsNeurocysticercosis Taenia solium Cysticercosis Mycobacterium tuberculosis
- 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
- 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