Journal of Global Infectious DiseasesOfficial Publishing of INDUSEM and OPUS 12 Foundation, Inc. Users online:929  
Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size     
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
 


 
   Table of Contents     
CASE REPORT  
Year : 2011  |  Volume : 3  |  Issue : 3  |  Page : 306-308
Imaging findings of disseminated cysticercosis with unusual involvement of spleen and pancreas


Department of Radiology, B.Y.L. Nair Charitable Hospital, Mumbai Central, Mumbai, India

Click here for correspondence address and email

Date of Web Publication6-Aug-2011
 

   Abstract 

In this study, we present a case of disseminated cysticercosis involving the brain, orbit, myocardium, muscle, subcutaneous tissues, pancreas, and spleen. Imaging studies are described with emphasis on pancreatic and splenic involvement which is a rare manifestation of a rather common disease and has been radiologically demonstrated only once previously. Although the involvement of the pancreas by parasites leading to pancreatitis has been described previously, in our case there was no clinical or biochemical evidence of pancreatitis due to infection by cysticerci.

Keywords: Cysticercosis, Pancreas, Spleen

How to cite this article:
Jakhere SG, Chemburkar VC, Yeragi BS, Bharambay HV. Imaging findings of disseminated cysticercosis with unusual involvement of spleen and pancreas. J Global Infect Dis 2011;3:306-8

How to cite this URL:
Jakhere SG, Chemburkar VC, Yeragi BS, Bharambay HV. Imaging findings of disseminated cysticercosis with unusual involvement of spleen and pancreas. J Global Infect Dis [serial online] 2011 [cited 2019 Aug 24];3:306-8. Available from: http://www.jgid.org/text.asp?2011/3/3/306/83547



   Introduction Top


Cysticercosis is a systemic parasitic infestation caused by the pork tapeworm Taenia solium. The tapeworm responsible for causing cysticercosis is endemic to many parts of the developing world including India. Disseminated cysticercosis is a rare form of cysticercosis caused by dissemination of the larval form of the pork tapeworm. Fewer than 50 cases have been reported worldwide, the majority being from India. [1] In a large study of 450 cases of cysticercosis, only one case of disseminated disease was seen. [2] To the best of our knowledge, only one case of pancreatic and splenic involvement by cysticercosis has been published till date. [3]


   Case Report Top


A 35-year-old man presented with multiple small swellings all over the body which had gradually increased in size and number over the last one year. He also had high-grade fever with chills, severe headache and blurring of vision for the last 3 days. A whole body magnetic resonance imaging (MRI) was done which showed multiple well-defined oval lesions involving almost all the muscles of the axial and the appendicular skeleton [Figure 1]. The lesions appeared bright on T2-weighted images, dark on T1-weighted images, and few of them showed an enhancing mural nodule inside on postcontrast images characteristic of a cysticercus. The entire brain parenchyma was studded with similar lesions giving a typical "starry sky" appearance of disseminated neurocysticercosis [Figure 2]. Cysticerci were also seen involving the orbits and the temporalis muscles bilaterally [Figure 3]. A CT abdomen showed similar lesions involving midregion of the spleen [Figure 4] and the body and head of the pancreas [Figure 5] and [Figure 6] sparing the uncinate process. A biopsy was taken from rectus femoris muscle which showed the larval form of the T. solium with mononuclear inflammatory changes [Figure 7]. The patient was treated with intravenous mannitol and dexamethasone to which he rapidly responded.
Figure 1: Whole body T2W image showing multiple cysticerci involving almost all muscles of the axial and appendicular skeleton

Click here to view
Figure 2: T2-weighted MRI brain image showing "starry sky" sign of disseminated neurocysticercosis. Arrow points toward the cysticercus

Click here to view
Figure 3: T2-weighted MRI image showing multiple cysticerci (arrow) involving both orbits with proptosis

Click here to view
Figure 4: CT image showing cysticercus (arrow) involving the midregion of the spleen. Multiple cysticerci are also seen in the paraspinal muscles

Click here to view
Figure 5: CT images showing cysticerci (arrows) in the head of pancreas

Click here to view
Figure 6: CT images showing cysticerci (arrow) in the tail of pancreas

Click here to view
Figure 7: Hematoxylin and eosin stained histopathology image showing larval form of cysticercus embedded within the muscle fiber

Click here to view


Disseminated cysticercosis is a rare form of cysticercosis caused by dissemination of the larval form of the pork tapeworm T. solium. Fewer than 50 cases have been reported worldwide, the majority being from India. [1] In a large study of 450 cases of cysticercosis, only one case of disseminated disease was seen. [2] To the best of our knowledge, only one case of pancreatic and splenic involvement by cysticercosis has been published till date. [3]

The disseminated form of cysticercosis is an uncommon manifestation of common disease and involvement of the pancreas and spleen is even rarer. CT and MR imaging are the modalities of choice for diagnosis of the disseminated form because of their noninvasive nature and excellent soft tissue contrast.


   Conclusion Top


In conclusion, disseminated cysticercosis is a rare disease entity with involvement of the pancreas and the spleen being still rarer. CT and MRI remain the diagnostic modalities of choice because of their excellent soft tissue contrast.

 
   References Top

1.Bhalla A, Sood A, Sachdev A, Varma V. Disseminated cysticercosis: A case report and review of literature. J Med Case Reports 2008;2:137.  Back to cited text no. 1
    
2.Dixon HB, Lipscomb FM. Cysticercosis: An analysis and follow-up of 450 cases. Medical Research Council Special Report Series No 299. London: Her Majesty's Stationery Office; 1961. p. 1-58.  Back to cited text no. 2
    
3.Scholtz L, Mentis H. Pulmonary cysticercosis. S Afr Med J 1987;72:573-4.  Back to cited text no. 3
    

Top
Correspondence Address:
Sandeep G Jakhere
Department of Radiology, B.Y.L. Nair Charitable Hospital, Mumbai Central, Mumbai
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.83547

Rights and Permissions


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]

This article has been cited by
1 Disseminated cysticercosis: Rare manifestation of a common disease
Singh, N. and Singh, D.K. and Parihar, A. and Singh, R.
BMJ Case Reports. 2012; (A1450)
[Pubmed]
2 Spleen
Noguerol, T.M. and Garrido, G. and Luna, A.
Learning Imaging. 2012; 8: 79-104
[Pubmed]
3 Pancréas parasitaire
P. Rey,M.-P. Massoure-Sockeel,G. Cinquetti,J.-M. Puyhardy
EMC - Hépatologie. 2012; 7(4): 1
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
   Introduction
   Case Report
   Conclusion
    References
    Article Figures

 Article Access Statistics
    Viewed4881    
    Printed130    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    
    Cited by others 3    

Recommend this journal

Sitemap | What's New | Feedback | Copyright and Disclaimer | Contact Us
© 2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008