Disseminated neurocysticercosis with bilateral papilledema: a case report

Ruchi Shrestha,Amin Kumar Shrestha

doi:10.1186/s13256-019-2227-0

Ruchi Shrestha, Amin Kumar Shrestha

Open Access

https://doi.org/10.1186/s13256-019-2227-0

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Abstract

BackgroundOcular cysticercosis is a disease which rarely involves cutaneous skin and the optic nerve. Patients with clinical presentation of subcutaneous nodules and papilledema should always be evaluated for cysticercosis.Case presentationWe report a rare case of ocular cysticercosis with multiple disseminated subcutaneous nodules and papilledema in both eyes. A 22-year-old Brahmin man presented with complaints of gradual loss of vision in both eyes and multiple small masses all over his body. On clinical evaluation, multiple subcutaneous nodules were seen on his face, mandibular area, elbow, arm, and abdomen. A fundus evaluation showed bilateral blurred disc margin. The case was managed with steroids and anti-parasitic drugs.ConclusionThis case report highlights the importance of ruling out neurocysticercosis in cases with multiple disseminated subcutaneous nodules and papilledema.

Highlights

BackgroundHuman cysticercosis is an accidental event, which results from either ingestion of cysticercus larvae in raw or inadequately cooked pork or ingestion of Taenia solium in contaminated water, food, and vegetables, or autoinfection due to poor hygiene [1]
Ocular cysticercosis is a disease which rarely involves cutaneous skin and the optic nerve
We report a rare case of ocular cysticercosis with multiple disseminated subcutaneous nodules on the body with bilateral papilledema with multiple calcified cysts with scolex in brain parenchyma and cerebellum on computed tomography (CT) scan

Summary

Background

Human cysticercosis is an accidental event, which results from either ingestion of cysticercus larvae in raw or inadequately cooked pork or ingestion of Taenia solium in contaminated water, food, and vegetables, or autoinfection due to poor hygiene [1]. We report a rare case of ocular cysticercosis with multiple disseminated subcutaneous nodules on the body with bilateral papilledema with multiple calcified cysts with scolex in brain parenchyma and cerebellum on computed tomography (CT) scan. Ocular cysticercosis is a disease which rarely involves cutaneous skin and optic nerve This case report highlights the importance of always evaluating patients with clinical presentation of subcutaneous nodules and papilledema for cysticercosis. It was associated with complaints of headache and dizziness for 1 month He had a history of multiple painless swellings over his body for the past 1 year. Multiple swellings were present on his face, mandibular area, elbow, arm, and abdomen His headache was intense on awakening and bending down position. There was no significant social and environmental history On examination he was healthy and well oriented to time, place, and person.

Discussion

Conclusion