Intramedullary parasite eggs, latent for three decades, mimicking acute transverse myelitis

• Published in: BMC infectious diseases Vol. 22; no. 1; p. 9
• Main Authors: Kim, Hyo-Jeong, Kim, Se-Hoon, Jeong, Hoi-Seon, Kim, Bum-Joon
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04-01-2022; BioMed Central; BMC
• Subjects: Acute transverse myelitis; Animal cognition; Animals; Antibodies; Antigens; Antiparasitic agents; Aquaporins; Biopsy; Brown-Sequard Syndrome; Calcification; Cancer; Case Report; Case reports; Case studies; Central nervous system parasitic infections; Cysts; Diagnosis; Edema; Eggs; Epidemiology; Female; Humans; Infections; Inflammatory diseases; Laboratories; Magnetic Resonance Imaging; Medical imaging; Middle Aged; Mimicry; Mortality; Myelitis; Myelitis, Transverse - diagnosis; Neurocysticercosis; Outpatient care facilities; Parasite eggs; Parasites; Parasitic diseases; Physiological aspects; Spinal cancer; Spinal cord; Spinal Cord Diseases - diagnostic imaging; Spinal cord neoplasm; Spinal diseases; Surgery; Transverse myelitis; Tumors; South Korea; Central nervous system parasitic infections; Acute transverse myelitis; Parasite eggs; Neurocysticercosis; Brown-Sequard syndrome; Spinal cord neoplasm
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-07013-7

Intramedullary parasitic infection is extremely uncommon, and clinical presentation of Brown-Sequard syndrome is even rarer.
The authors report a case involving a 57-year-old woman with Brown-Sequard syndrome, in whom magnetic resonance imaging and clinical and epidemiological features were similar to those of acute transverse myelitis. Myelotomy suggested inflammation caused by latent parasite eggs in the spinal cord. Antiparasitic and steroid therapies were administered postoperatively. To the author's knowledge, this is the first report to describe a surgical experience for Taenia solium eggs in the spinal cord.
Intramedullary parasitic infection is a diagnostic challenge that requires careful discrimination from other diseases. If parasite infection is suspected in a progressively deteriorating patient, myelotomy should be considered for rapid and accurate treatment.