Parasitic brain infections: Difference between revisions

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

@@ Line 1: / Line 1: @@
-== Differential Diagnosis ==
+==Differential Diagnosis==
 {| class="wikitable"
 !Parasite
 !Disease
 !Lesion
+!Clinical Clues
-!Location
 |-
 ! colspan="4" |Protozoa
 |-
-|[[Balamuthia mandrillaris]] and [[Acanthamoeba species]]
+|[[Balamuthia mandrillaris]] and [[Acanthamoeba]]
 |[[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]]
 |
+|travel to endemic country
-|
 |-
-|[[Microsporidia species]]
+|[[Microsporidia]]
 |[[Microsporidiasis]]
 |
@@ Line 25: / Line 25: @@
 |[[Naegleria fowleri]]
 |[[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
 |
@@ Line 40: / Line 40: @@
 |[[Trypanosoma brucei]]
 |[[African trypanosomiasis]]
-|diffuse hyperintensity on T1
+|diffuse hyperintensity on T1 usually involving bilateral basal ganglia
+|
-|bilateral basal ganglia
 |-
 |[[Trypanosoma cruzi]]
 |[[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
 |-
-|[[Paragonimus species]]
+|[[Paragonimus]]
 |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]]
-|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
@@ Line 64: / Line 64: @@
 |[[Echinococcus granulosus]]
 |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]]
 |Alveolar hydatid disease
 |contrast-enhancing round, solid lesions with surrounding edema on T2
-|any
+|
 |-
 |[[Taenia solium]]
@@ Line 77: / Line 77: @@
 |
 |-
-|[[Taenia species]]
+|[[Taenia]]
 |[[Coenurosis]]
 |
 |
 |-
-|[[Spirometra species]]
+|[[Spirometra]]
 |[[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
 |-
-|[[Gnathostoma species]]
+|[[Gnathostoma]]
 |[[Gnathostomiasis]]
 |
@@ Line 99: / Line 99: @@
 |
 |-
-|[[Toxocara species]]
+|[[Toxocara]]
 |[[Toxocariasis]]
 |
@@ Line 129: / Line 129: @@
 |
 |-
-|[[Lagochilascaris species]]
+|[[Lagochilascaris]]
 |[[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]]