1/28. Approach via the floor of the fourth ventricle for hydatid cyst of the pons. A very rare case of a pontine hydatid cyst is reported. It was diagnosed preoperatively on the basis of magnetic resonance imaging findings. The patient was operated on in the sitting position. Total excision of the cyst using the Dowling technique and gravity effect was performed through the floor of the fourth ventricle. The patient was discharged without extra neurological sequel. The significance of an accurate preoperative diagnosis, surgical approaches and technique in the management of this pathology is discussed. ( info) |
2/28. Malakoplakia of the appendix. An unusual association with eggs of Taenia species. Malakoplakia of the appendix is an unusual condition that has been reported to occur in association with tumors, infections, and immunocompromised states. We describe a case of appendicular malakoplakia associated with eggs of Taenia species. The diagnosis was made on histopathologic examination of surgically resected tissue from an appendicular mass. To the best of our knowledge, this is the first time that helminths have been documented to be associated with malakoplakia. We also discuss the implications of helminthic infestation in the pathogenesis of the lesion. ( info) |
3/28. Ultrasonographic appearance of colon taeniasis. We present the case of a 50-year-old woman with abdominal pain, nausea, loss of appetite, and frequent stools in whom the routine ultrasonographic examination demonstrated a double-reflective, ribbon-like structure in the lumen of the initial segment of the ascending colon, which suggested colon taeniasis. Because the initial parasitologic analysis yielded negative results and application of albendazol did not have any therapeutic effect, the diagnosis was confirmed by barium enema and subsequently by parasitologic examination of proglottids passed in the stool after application of niclosamide. The double-reflective, ribbon-like structure in the lumen of the intestine seems to be specific to the ultrasonographic appearance of intestinal taeniasis. Transcutaneous ultrasonography of the gastrointestinal tract, performed as a screening method before conventional radiologic or endoscopic examination, can point to the ultimate diagnosis of colon taeniasis. ( info) |
| A thirteen-year old girl presented with acute right lower quadrant abdominal pain for which evaluation suggested appendicitis. At laparotomy, the appendix was normal but a Meckel's diverticulum with an impacted taenia saginata (tapeworm) was found. The diverticulum was excised and histopathology confirmed diverticulitis from the parasite. Though Meckel's diverticulitis due to parasites has been reported, this is usually from ascaris. Tapeworm causing this complication is rare. ( info) |
| Surgical complications of taenia saginata infection, the bovine tapeworm which man acquires by eating undercooked beef, are mentioned in standard texts; however, none of these seem to give any specific reference. Reported here is one case of acute mechanical intestinal obstruction due to a bolus impaction of taenia saginata at the level of the ileocaecal valve. The rarity of this clinical presentation as well as the probable mechanism of obstruction are discussed. ( info) |
6/28. Case of megaloblastic anemia caused by intestinal taeniasis. A 61-year-old eutrophic male was diagnosed with vitamin B12 deficiency and megaloblastic anemia. A modified schilling test suggested intestinal malabsorption unrelated to intrinsic factor deficiency. Subsequent colonoscopy revealed the presence of a Taenia tapeworm. The anemia resolved within days under therapy with niclosamide and temporary vitamin B12 supplements. The present case suggests that, in addition to other well-known parasitic agents, e.g., diphyllobothrium latum and giardia lamblia, Taenia infestation can also be a cause of intestinal vitamin B12 malabsorption. ( info) |
7/28. Unusual manifestations of taenia solium infestation. We present two rare cases of unusual manifestations of taenia solium infestation. Taenia infestation usually causes abdominal pain and diarrhea in humans. But there have been no clinical reports of ascites, chronic diarrhea, and malabsorption due to taenia solium without evidence of the ova or larvae of the parasites in stool examinations. Our first unusual case was in a 30-year-old woman with spontaneous pneumothorax, pleural effusion, and ascites; the second case was in a 67-year-old man with a 3-year history of diarrhea, weight loss, and indigestion. Both patients showed blood eosinophilia and positive serologic tests for taenia solium. After antiparasitic agent administration, their symptoms resolved successfully. ( info) |
| A Japanese woman presenting with neurologic symptoms was presumptively diagnosed with neurocysticercosis based on imaging findings. Hooklets in the scolex of the resected lesion were not confirmed through histopathological observation. However, the illness was confirmed by mitochondrial dna analysis to be a solitary neurocysticercosis case caused by the Asian genotype of taenia solium. ( info) |
| A case of neurocysticercosis in a six-year-old Mexican boy and a case of taenia solium taeniasis in his five-year-old brother are reported. neurocysticercosis was suspected based on clinical findings and was confirmed by computed tomography scanning. A parasitologic examination with zinc-sulfate flotation and formalin-ether sedimentation techniques was carried out on the whole family, and revealed Taenia sp. eggs in three stool samples from the five-year-old boy. The entire family agreed to undergo chemotherapy with niclosamide, but only the child passing taeniid eggs eliminated T. solium. No additional taeniasis cases were found in an examination of 20% of the village population, using the same parasitologic techniques. The results of an ELISA using cysticercus antigens were negative for the boy with neurocysticercosis, for other family members, and for 24 village volunteers, but were positive for the T. solium tapeworm carrier. It was concluded that in this family, person-to-person transmission of the tapeworm occurred due to poor living conditions and hygiene. ( info) |
10/28. Jejunal perforation caused by morphologically abnormal taenia saginata saginata infection. We report a case of jejunal perforation caused by infection with taeniid tapeworm possessing unusual morphology that has not been previously described. Among five cestodes recovered during operation, one exhibited a bifurcation at the posterior end and the other harbored a lateral branching of immature segments from the main strobila. By sequence analysis of the mitochondrial cytochrome c oxidase I gene and the 28S rRNA gene has confirmed them to be taenia saginata saginata. ( info) |