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Multiple microembolic brain infarctions in Clonorchis sinensis infestation.

Kyoung Jin Hwang¹, Sung Hyuk Heo, Dae-Il Chang

¹Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea.

Journal of the Neurological Sciences

|June 5, 2012

Summary

A rare case linked hypereosinophilia and Clonorchis sinensis parasitic infection to multiple cerebral infarctions. Prompt praziquantel treatment led to patient recovery, highlighting the parasite

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Area of Science:

Parasitology
Neurology
Internal Medicine

Background:

Hypereosinophilic syndrome (HES) is a group of disorders characterized by sustained eosinophilia.
Cerebral infarctions, often caused by microemboli, can be idiopathic or linked to various underlying conditions.
Clonorchis sinensis, a liver fluke endemic in East Asia, is a known parasitic cause of eosinophilia.

Observation:

A patient presented with multiple cerebral infarctions as the initial symptom.
Diagnostic workup revealed sustained hypereosinophilia and elevated cardiac enzymes.
Stool examination confirmed the presence of Clonorchis sinensis eggs, and imaging showed eosinophilic infiltration in the lungs and liver.

Findings:

The case demonstrates a direct link between Clonorchis sinensis infestation and the development of multiple cerebral infarctions.

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The patient's hypereosinophilia and organ involvement were attributed to the parasitic infection.

Successful treatment with praziquantel resulted in complete clinical recovery within six weeks.

Implications:

Clonorchis sinensis infestation should be considered in the differential diagnosis of patients presenting with unexplained hypereosinophilia and embolic strokes.
This case expands the known clinical manifestations of Clonorchis sinensis infection.
Early diagnosis and treatment of parasitic infections can prevent severe neurological complications like stroke.