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Cerebral sparganosis in a child
1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, South Korea.
Insights
Pediatric cerebral sparganosis is rare. A 6-year-old girl presented with a migrating brain lesion and seizures, diagnosed via antibody testing and confirmed by surgical removal of a worm.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Cerebral sparganosis, a rare parasitic infection of the brain, is exceptionally uncommon in children.
- Prior to 1996, only two pediatric cases of cerebral sparganosis had been documented.
Purpose of the Study:
- To report a rare case of cerebral sparganosis in a pediatric patient.
- To highlight the diagnostic challenges and clinical presentation of this condition in children.
Main Methods:
- Case presentation of a 6-year-old girl with neurological symptoms.
- Serial brain magnetic resonance imaging (MRI) to track lesion migration.
- Enzyme-linked immunosorbent assay (ELISA) for antisparganum antibodies.
- Surgical removal of the parasitic worm and surrounding granulomatous tissue.
Main Results:
- The patient presented with seizures and a migrating brain lesion observed over four months on serial MRI scans.
- ELISA confirmed the presence of antisparganum antibodies.
- A live sparganum worm was surgically removed, leading to a negative antibody conversion 12 months post-surgery.
- The likely source of infection was contaminated spring water.
Conclusions:
- Cerebral sparganosis should be considered in endemic areas, even in pediatric patients, presenting with migrating granulomatous brain lesions.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
- This case underscores the importance of considering rare parasitic infections in the differential diagnosis of pediatric neurological disorders.
Abstract:
Cerebral sparganosis in childhood is very rare. Until 1996, 2 cases in children up to 15 years of age had been described. We report a case of cerebral sparganosis in a 6-year-old girl who presented with seizures. Sequential brain magnetic resonance imaging scans spaced over 4 months showed a lesion which migrated from the right parieto-occipital region to the right occipital region. The enzyme-linked immunosorbent assay for antisparganum antibody was positive. She most likely contracted sparganosis from worm-infested spring-water. A live worm with surrounding granulomatous tissue was removed, and the enzyme-linked immunosorbent assay for antisparganum antibody converted to negative 12 months following surgery. In areas of endemic sparganosis, the possibility of cerebral sparganosis should be considered, even in a child, if the patient shows a migrating granulomatous lesion.