Paragonimiasis presenting as an acute hemorrhagic stroke

Area of Science:

• Neurology
• Infectious Diseases
• Parasitology

Background:

• Cerebral paragonimiasis is a rare parasitic infection of the central nervous system (CNS).
• It typically affects younger individuals and can present with diverse neurological symptoms.
• Prompt diagnosis and treatment are crucial for favorable outcomes.

Observation:

• A 19-year-old male presented with symptoms consistent with a hemorrhagic stroke, including headache and blurred vision.
• Imaging revealed cystic lesions and linear tracking in the brain and chest, suggestive of parasitic involvement.
• Cerebrospinal fluid (CSF) analysis indicated pleocytosis with eosinophilia.

Findings:

• Serological testing confirmed the diagnosis of paragonimiasis.
• The patient received treatment with praziquantel, corticosteroids, and anti-epileptic drugs.
• The patient was discharged in stable condition, highlighting the treatability of CNS paragonimiasis.

Implications:

• Cerebral paragonimiasis should be considered in the differential diagnosis of acute neurological presentations, particularly in young individuals.
• This case underscores the importance of recognizing rare parasitic infections that can mimic common neurological emergencies.
• Timely and accurate diagnosis of CNS paragonimiasis is essential for effective management and improved patient prognosis.