Hymenolepis diminuta Infection in a Romanian Child from an Urban Area

Hymenolepis diminuta is primarily a rodent parasite that is ubiquitously distributed worldwide, but with only a few cases described as human infections. We report a case of Hymenolepis diminuta infection in a 15-month-old child, living in an urban setting, with no previous medical history. The patient presented with two episodes of seizures, and complaints of abdominal pain, vomiting, and diarrhea, with no apparent history of rodent contact. Furthermore, the patient's gastrointestinal symptoms were linked to the emission of suspected tapeworm proglottids in the feces. After excluding other possible etiologies, a diagnosis of Hymenolepis diminuta infection was made, based on the examination of characteristic eggs in a concentrated stool specimen. The infant was successfully treated with praziquantel and fully recovered. After two weeks, the stool sample was free of Hymenolepis diminuta eggs. The clinical follow-up over the next 3 years was normal. Hymenolepis diminuta is rarely found in humans, and, when present, the infection is frequently asymptomatic. Abdominal pain, irritability, itching, eosinophilia, and seizures have also been reported. In this paper, we report, for the first time in the literature, an infection with Hymenolepis diminuta in a Romanian infant who had atypical neurological presentation, with full recovery, without subsequent neurological sequelae.