Parasitic brain infections: Difference between revisions
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==Differential Diagnosis== |
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{| class="wikitable" |
{| class="wikitable" |
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!Parasite |
!Parasite |
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!Disease |
!Disease |
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!Lesion |
!Lesion |
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!Clinical Clues |
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!Location |
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! colspan="4" |Protozoa |
! colspan="4" |Protozoa |
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|[[Balamuthia mandrillaris]] and [[Acanthamoeba species]] |
|[[Balamuthia mandrillaris]] and [[Acanthamoeba species]] |
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|[[Granulomatous amoebic encephalitis]] |
|[[Granulomatous amoebic encephalitis]] |
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|single or multiple ring-enhancing lesions with surrounding edema and mass effect |
|single or multiple ring-enhancing lesions in the gray and white matter with surrounding edema and mass effect |
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|exposure to warm water |
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|gray and white matter |
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|[[Leishmania species]] |
|[[Leishmania species]] |
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|[[Leishmaniasis]] |
|[[Leishmaniasis]] |
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|travel to endemic country |
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|[[Microsporidia species]] |
|[[Microsporidia species]] |
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|[[Naegleria fowleri]] |
|[[Naegleria fowleri]] |
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|[[Primary amebic meningoencephalitis]] |
|[[Primary amebic meningoencephalitis]] |
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|global edema, stroke, and elevated intracranial pressure |
|global edema, stroke, and elevated intracranial pressure, most commonly in the base of the brain |
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|exposure to warm water, rapid progression |
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|base of brain most common |
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|[[Plasmodium species]] |
|[[Plasmodium species]] |
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|[[Trypanosoma brucei]] |
|[[Trypanosoma brucei]] |
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|[[African trypanosomiasis]] |
|[[African trypanosomiasis]] |
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|diffuse hyperintensity on T1 |
|diffuse hyperintensity on T1 usually involving bilateral basal ganglia |
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|bilateral basal ganglia |
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|[[Trypanosoma cruzi]] |
|[[Trypanosoma cruzi]] |
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|[[Chagas disease]] |
|[[Chagas disease]] |
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|contrast-enhancing hypointense T1 lesions with edema on T2 |
|contrast-enhancing hypointense T1 lesions involving only the parietal and frontal lobes, with edema on T2 |
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|parietal and frontal lobes only |
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! colspan="4" |Metazoa: Trematodes |
! colspan="4" |Metazoa: Trematodes |
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|[[Paragonimus species]] |
|[[Paragonimus species]] |
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|Paragonimiasis |
|Paragonimiasis |
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|inflammatory changes surrounding clusters of contrast-enhancing lesions |
|inflammatory changes surrounding clusters of contrast-enhancing lesions, most commonly in the frontal and temporal gray and white matter |
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|frontal and temporal gray and white matter most common |
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|[[Schistosoma species]] |
|[[Schistosoma species]] |
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|[[Schistosomiasis]] |
|[[Schistosomiasis]] |
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|central linear enhancement, clustered with arborized appearance |
|central linear enhancement, clustered with arborized appearance, and commonly involves spinal cord with [[Schistosoma haematobium]] |
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|can include spinal cord, especially with [[Schistosoma haematobium]] |
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! colspan="4" |Metazoa: Cestodes |
! colspan="4" |Metazoa: Cestodes |
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|[[Echinococcus granulosus]] |
|[[Echinococcus granulosus]] |
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|Intracranial hydatidosis |
|Intracranial hydatidosis |
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|multiple thin-walled, large, round cysts, or one large cyst with smaller surrounding cysts |
|multiple thin-walled, large, round cysts, or one large cyst with smaller surrounding cysts, most commonly in the parietal lobe |
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|parietal most common |
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|[[Echinococcus multilocularis]] |
|[[Echinococcus multilocularis]] |
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|Alveolar hydatid disease |
|Alveolar hydatid disease |
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|contrast-enhancing round, solid lesions with surrounding edema on T2 |
|contrast-enhancing round, solid lesions with surrounding edema on T2 |
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|[[Taenia solium]] |
|[[Taenia solium]] |
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|[[Spirometra species]] |
|[[Spirometra species]] |
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|[[Sparganosis]] |
|[[Sparganosis]] |
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|T2 edema, sometimes with T1 mass or linear or curvilinear contrast-enhancing lesions |
|T2 edema, sometimes with T1 mass or linear or curvilinear contrast-enhancing lesions, most commonly involving frontal and parietal lobes |
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|frontal and parietal lobes most common |
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! colspan="4" |Metazoa: Nematodes |
! colspan="4" |Metazoa: Nematodes |
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<br /> |
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== Further Reading == |
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* Parasitic diseases of the central nervous system: lessons for clinicians and policy makers. ''Expert Rev Neurother''. 2016;16(4): 401–414. doi: [https://doi.org/10.1586/14737175.2016.1155454 10.1586/14737175.2016.1155454] |
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[[Category:Parasites]] |
[[Category:Parasites]] |
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Revision as of 14:25, 3 December 2020
Differential Diagnosis
| Parasite | Disease | Lesion | Clinical Clues |
|---|---|---|---|
| Protozoa | |||
| Balamuthia mandrillaris and Acanthamoeba species | Granulomatous amoebic encephalitis | single or multiple ring-enhancing lesions in the gray and white matter with surrounding edema and mass effect | exposure to warm water |
| Leishmania species | Leishmaniasis | travel to endemic country | |
| Microsporidia species | Microsporidiasis | ||
| Naegleria fowleri | Primary amebic meningoencephalitis | global edema, stroke, and elevated intracranial pressure, most commonly in the base of the brain | exposure to warm water, rapid progression |
| Plasmodium species | Malaria | ||
| Toxoplasma gondii | Toxoplasmosis | ||
| Trypanosoma brucei | African trypanosomiasis | diffuse hyperintensity on T1 usually involving bilateral basal ganglia | |
| Trypanosoma cruzi | Chagas disease | contrast-enhancing hypointense T1 lesions involving only the parietal and frontal lobes, with edema on T2 | |
| Metazoa: Trematodes | |||
| Paragonimus species | Paragonimiasis | inflammatory changes surrounding clusters of contrast-enhancing lesions, most commonly in the frontal and temporal gray and white matter | |
| Schistosoma species | Schistosomiasis | central linear enhancement, clustered with arborized appearance, and commonly involves spinal cord with Schistosoma haematobium | |
| Metazoa: Cestodes | |||
| Echinococcus granulosus | Intracranial hydatidosis | multiple thin-walled, large, round cysts, or one large cyst with smaller surrounding cysts, most commonly in the parietal lobe | |
| Echinococcus multilocularis | Alveolar hydatid disease | contrast-enhancing round, solid lesions with surrounding edema on T2 | |
| Taenia solium | Neurocysticercosis | single or multiple ring-enhancing lesions, with calcifications if older | |
| Taenia species | Coenurosis | ||
| Spirometra species | Sparganosis | T2 edema, sometimes with T1 mass or linear or curvilinear contrast-enhancing lesions, most commonly involving frontal and parietal lobes | |
| Metazoa: Nematodes | |||
| Gnathostoma species | Gnathostomiasis | ||
| Angiostrongylus cantonensis | Angiostrongyliasis | ||
| Toxocara species | Toxocariasis | ||
| Strongyloides stercoralis | Strongyloidiasis | ||
| multiple | Filariasis | ||
| Baylisascaris procyonis | Baylisascariasis | ||
| Dracuncula medinensis | Dracunculiasis | ||
| Dicrocoelium dendriticum | Dicrocoeliasis | ||
| Lagochilascaris species | Lagochilascariasis | ||
Further Reading
- Parasitic diseases of the central nervous system: lessons for clinicians and policy makers. Expert Rev Neurother. 2016;16(4): 401–414. doi: 10.1586/14737175.2016.1155454
