Cerebral paragonimiasis: a retrospective analysis of 27 cases.
OBJECT
The authors retrospectively analyzed the clinical characteristics, existing problems, and treatment experiences in recently diagnosed cerebral paragonimiasis (CP) cases and sought to raise awareness of CP and to supply reference data for early diagnosis and treatment.


METHODS
Twenty-seven patients (22 male and 5 female; median age 20.3 years, range 4-47 years) with CP were diagnosed between September 2008 and September 2013. These diagnoses were confirmed by IgG enzyme-linked immunosorbent assays. Follow-up was performed in 24 cases for a period of 6-56 months.


RESULTS
Cerebral paragonimiasis accounted for 21.6% of paragonimiasis cases (27 of 125). The average duration from onset to praziquantel treatment was 69 days. All patients resided in rural areas. Twenty patients had positive lung results, which included visible lung lesions in 14 cases. The lesions were surgically removed in 8 of these cases. Twenty-four patients had high eosinophil counts (≥ 0.08 × 10(9)/L), and eosinophilic meningitis was noted in 17 cases. The rate of misdiagnosis and missed diagnosis was 30.4%. Most symptoms were markedly improved after treatment, but mild movement disorders combined with impaired memory and personality changes remained in a small number of patients.


CONCLUSIONS
Clinicians should be alert to the possibility of CP in young patients (4-16 years) with the primary symptoms of epilepsy and hemorrhage. Early diagnosis and timely treatment can reduce the need for surgery and further impairments to brain function. Liquid-based cytological examination of CSF and peripheral blood eosinophil counts can aid in differentiating CP from similar lesions.
['Xia|Yong|Y|', 'Ju|Yan|Y|', 'Chen|Jing|J|', 'You|Chao|C|']
D000293:Adolescent D000328:Adult D000871:Anthelmintics D020807:Central Nervous System Parasitic Infections D002648:Child D002675:Child, Preschool D002681:China D003937:Diagnosis, Differential D042241:Early Diagnosis D004797:Enzyme-Linked Immunosorbent Assay D004827:Epilepsy D005260:Female D006801:Humans D008174:Lung Diseases, Parasitic D008297:Male D008875:Middle Aged D010237:Paragonimiasis D010784:Photomicrography D011223:Praziquantel D012189:Retrospective Studies D012424:Rural Population D014057:Tomography, X-Ray Computed D016896:Treatment Outcome D055815:Young Adult
cerebral paragonimiasis praziquantel surgery CP = cerebral paragonimiasis ELISA = enzyme-linked immunosorbent assay Paragonimus skrjabini Paragonimus westermani infection