第一例记录的孤立小脑型日本血吸虫神经血吸虫病,通过病变的实时聚合酶链反应确诊:说明性病例。

Edmund John B Cayanong, Natalie Roxanne B Nisce, John Carlo B Reyes, Jeanne Mara M Gopeng, Mary Angeline Luz U Hernandez, Kathleen Joy O Khu
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引用次数: 0

摘要

背景:神经血吸虫病是一种罕见的血吸虫感染表现,通常影响脊髓和幕上脑区。小脑受累是非常罕见的,经常表现为影像学上的多个强化病灶,模仿肿瘤的过程。孤立的小脑病变更为罕见。本文报道了首例由日本血吸虫引起的脑组织实时聚合酶链反应(RT-PCR)证实的孤立性小脑神经血吸虫病病例。观察结果:一名来自流行地区的33岁男性,有3个月的进行性头痛、呕吐和身体失衡史。影像学显示单发右脑病变伴阻塞性脑积水。放置脑室-腹膜分流管,然后切除肿瘤。术中及组织病理学检查显示为血吸虫卵。福尔马林固定石蜡包埋组织的RT-PCR鉴定。患者给予吡喹酮和地塞米松治疗,随访6个月无症状。与以前的报道不同,本病例涉及孤立病变和延长的症状过程,RT-PCR直接从脑组织证实了诊断。经验教训:孤立性小脑神经血吸虫病可以模拟肿瘤,在流行地区应予以考虑。脑组织RT-PCR提供了一种有价值的诊断工具。及时的手术和医疗管理可以导致完全恢复,强调了考虑非典型颅内病变寄生虫感染的重要性。https://thejns.org/doi/10.3171/CASE25282。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
First documented case of solitary cerebellar Schistosoma japonicum neuroschistosomiasis confirmed by real-time polymerase chain reaction of the lesion: illustrative case.

Background: Neuroschistosomiasis is a rare manifestation of Schistosoma infection, typically affecting the spinal cord and supratentorial brain regions. Cerebellar involvement is exceedingly uncommon and often presents with multiple enhancing lesions on imaging, mimicking neoplastic processes. Solitary cerebellar lesions are even more unusual. The authors present the first reported case of solitary cerebellar neuroschistosomiasis confirmed via real-time polymerase chain reaction (RT-PCR) on brain tissue caused by Schistosoma japonicum.

Observations: A 33-year-old man from an endemic region presented with a 3-month history of progressive headache, vomiting, and imbalance. Imaging showed a solitary right cerebellar lesion with obstructive hydrocephalus. A ventriculoperitoneal shunt was placed, followed by tumor resection. Intraoperative and histopathological findings revealed schistosomal ova. RT-PCR on formalin-fixed paraffin-embedded tissue confirmed S. japonicum. The patient was treated with praziquantel and dexamethasone and remained asymptomatic at the 6-month follow-up. Unlike previous reports, this case involved a solitary lesion and a prolonged symptom course, with RT-PCR confirming the diagnosis directly from brain tissue.

Lessons: Solitary cerebellar neuroschistosomiasis can mimic tumors and should be considered in endemic areas. RT-PCR on brain tissue offers a valuable diagnostic tool. Timely surgical and medical management can lead to full recovery, emphasizing the importance of considering parasitic infections in atypical intracranial lesions. https://thejns.org/doi/10.3171/CASE25282.

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