The online version of this article (doi:10.1186/1752-1947-8-36) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
DY analyzed and interpreted the patient data and was a major contributor in writing the manuscript. CWJ performed the neuroimaging explanation of the cerebral lesions and helped to interpret the patient data. DQ designed and organized the study. All authors have read and approved the final manuscript.
The most serious erratic migration of paragonimiasis is a cerebral paragonimiasis. Infection in the temporal and occipital lobes of the brain has been previously reported in cerebral paragonimiasis. Here, we report a case of chronic brainstem paragonimiasis.
A 29-year-old Chinese woman presented to our hospital complaining of a sudden onset, three days previously, of double vision and dizziness. A computed tomography scan and diffusion-weighted images looked like an ischemic stroke. However, conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging, and the characteristic appearance of the ‘tunnel sign’, were found on further examination. Our patient was treated with praziquantel to prevent the spread of the paragonimiasis. She was followed up three months later and showed good recovery.
Conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging and the characteristic appearance of the ‘tunnel sign’ were important for the diagnosis of chronic brainstem paragonimiasis.
Bunnay D, Cross JH, Bunnay T: Lung fluke infections; paragonimiasis. Hunter’s tropical medicine and emerging infectious diseases. Edited by: Strickland GT. 2000, Philadelphia: W. B. Saunders Company, 847-851. Eighth
Cho SY: Epidemiology of paragonimiasis in Korea. Collected papers on parasite control in Korea. Edited by: Chai JY, Cho SY, Han IS, Lee SH, Rim HJ. 1994, Seoul, Korea: The Korea Association of Health, 51-57.
Chang KH, Cha SH, Han MH, Kim HD, Cho SY, Kong Y, Kang HK, Kim MS: An imaging diagnosis of cerebral paragonimiasis: CT and MR findings and correlation with ELISA antibody test. J Korean Radiol Soc. 1993, 29: 345-354.
Choo JD, Suh BS, Lee HS, Lee JS, Song CJ, Shin DW, Lee YH: Chronic cerebral paragonimiasis combined with aneurysmal subarachnoid hemorrhage. Am J Trop Med Hyg. 2003, 69: 466-469. PubMed
Beers MH, Berkow R: The Merck manual of diagnosis and therapy. 2002, Merck Research Laboratories: Rahway, NJ, 17
Oh SJ: The rate of cerebral involvement in paragonimiasis: an epidemiologic study. Jpn J Parasitol. 1969, 18: 211-214.
Kadota T, Ishikura R, Tabuchi Y, Nakao N, Fujikawa H, Kaba K, Tani E, Miura T: MR imaging of chronic cerebral paragonimiasis. AJNR. 1989, 10: S21-S22. PubMed
- Neuroimaging findings in a woman with brainstem paragonimiasis: a case report and review of the literature
- BioMed Central