Parasitic brain infections: Difference between revisions

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== Differential Diagnosis ==
==Differential Diagnosis==
{| class="wikitable"
{| class="wikitable"
!Parasite
!Parasite
!Disease
!Disease
!Lesion
!Lesion
!Clinical Clues
!Location
|-
|-
! colspan="4" |Protozoa
! colspan="4" |Protozoa
|-
|-
|[[Balamuthia mandrillaris]] and [[Acanthamoeba species]]
|[[Balamuthia mandrillaris]] and [[Acanthamoeba]]
|[[Granulomatous amoebic encephalitis]]
|[[Granulomatous amoebic encephalitis]]
|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
|exposure to warm water
|gray and white matter
|-
|-
|[[Leishmania species]]
|[[Leishmania]]
|[[Leishmaniasis]]
|[[Leishmaniasis]]
|
|
|travel to endemic country
⚫
|
|-
|-
|[[Microsporidia species]]
|[[Microsporidia]]
|[[Microsporidiasis]]
|[[Microsporidiasis]]
|
|
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|[[Naegleria fowleri]]
|[[Naegleria fowleri]]
|[[Primary amebic meningoencephalitis]]
|[[Primary amebic meningoencephalitis]]
|global edema, stroke, and elevated intracranial pressure
|global edema, stroke, and elevated intracranial pressure, most commonly in the base of the brain
|exposure to warm water, rapid progression
|base of brain most common
|-
|-
|[[Plasmodium species]]
|[[Plasmodium]]
|Malaria
|Malaria
|
|
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|[[Trypanosoma brucei]]
|[[Trypanosoma brucei]]
|[[African trypanosomiasis]]
|[[African trypanosomiasis]]
|diffuse hyperintensity on T1
|diffuse hyperintensity on T1 usually involving bilateral basal ganglia
⚫
|
|bilateral basal ganglia
|-
|-
|[[Trypanosoma cruzi]]
|[[Trypanosoma cruzi]]
|[[Chagas disease]]
|[[Chagas disease]]
|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
|
|parietal and frontal lobes only
|-
|-
! colspan="4" |Metazoa: Trematodes
! colspan="4" |Metazoa: Trematodes
|-
|-
|[[Paragonimus species]]
|[[Paragonimus]]
|Paragonimiasis
|Paragonimiasis
|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
|
|frontal and temporal gray and white matter most common
|-
|-
|[[Schistosoma species]]
|[[Schistosoma]]
|[[Schistosomiasis]]
|[[Schistosomiasis]]
|central linear enhancement, clustered with arborized appearance
|central linear enhancement, clustered with arborized appearance, and commonly involves spinal cord with [[Schistosoma haematobium]]
|
|can include spinal cord, especially with [[Schistosoma haematobium]]
|-
|-
! colspan="4" |Metazoa: Cestodes
! colspan="4" |Metazoa: Cestodes
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|[[Echinococcus granulosus]]
|[[Echinococcus granulosus]]
|Intracranial hydatidosis
|Intracranial hydatidosis
|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
|
|parietal most common
|-
|-
|[[Echinococcus multilocularis]]
|[[Echinococcus multilocularis]]
|Alveolar hydatid disease
|Alveolar hydatid disease
|contrast-enhancing round, solid lesions with surrounding edema on T2
|contrast-enhancing round, solid lesions with surrounding edema on T2
|any
|
|-
|-
|[[Taenia solium]]
|[[Taenia solium]]
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|
|
|-
|-
|[[Taenia species]]
|[[Taenia]]
|[[Coenurosis]]
|[[Coenurosis]]
|
|
|
|
|-
|-
|[[Spirometra species]]
|[[Spirometra]]
|[[Sparganosis]]
|[[Sparganosis]]
|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
|
|frontal and parietal lobes most common
|-
|-
! colspan="4" |Metazoa: Nematodes
! colspan="4" |Metazoa: Nematodes
|-
|-
|[[Gnathostoma species]]
|[[Gnathostoma]]
|[[Gnathostomiasis]]
|[[Gnathostomiasis]]
|
|
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|
|
|-
|-
|[[Toxocara species]]
|[[Toxocara]]
|[[Toxocariasis]]
|[[Toxocariasis]]
|
|
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|
|
|-
|-
|[[Lagochilascaris species]]
|[[Lagochilascaris]]
|[[Lagochilascariasis]]
|[[Lagochilascariasis]]
|
|
|
|
|}
|}

<br />
== Further Reading ==

* 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]

[[Category:Parasites]]
[[Category:Parasites]]

Latest revision as of 20:11, 12 February 2022

Differential Diagnosis

Parasite Disease Lesion Clinical Clues
Protozoa
Balamuthia mandrillaris and Acanthamoeba 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 Leishmaniasis travel to endemic country
Microsporidia 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 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 Paragonimiasis inflammatory changes surrounding clusters of contrast-enhancing lesions, most commonly in the frontal and temporal gray and white matter
Schistosoma 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 Coenurosis
Spirometra Sparganosis T2 edema, sometimes with T1 mass or linear or curvilinear contrast-enhancing lesions, most commonly involving frontal and parietal lobes
Metazoa: Nematodes
Gnathostoma Gnathostomiasis
Angiostrongylus cantonensis Angiostrongyliasis
Toxocara Toxocariasis
Strongyloides stercoralis Strongyloidiasis
multiple Filariasis
Baylisascaris procyonis Baylisascariasis
Dracuncula medinensis Dracunculiasis
Dicrocoelium dendriticum Dicrocoeliasis
Lagochilascaris 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
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