An unusual guest in an unusual location of the brain of a rural tribal man

Dinoop Korol Ponnambath; Jyothi Embekkat Kaviyil; Kavita Raja; Krishnakumar Kesavapisharady; Bejoy Thomas; Deepti Narasimhaiah; Rakesh Sehgal; Upninder Kaur

doi:10.4103/jacm.jacm_9_22

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Year : 2022 | Volume : 24 | Issue : 1 | Page : 44-47

An unusual guest in an unusual location of the brain of a rural tribal man

Dinoop Korol Ponnambath¹, Jyothi Embekkat Kaviyil¹, Kavita Raja¹, Krishnakumar Kesavapisharady², Bejoy Thomas³, Deepti Narasimhaiah⁴, Rakesh Sehgal⁵, Upninder Kaur⁵
¹ Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
² Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
³ Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
⁴ Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
⁵ Department of Medical Parasitology, Post Graduate Institute for Medical Education and Research, Chandigarh, India

Correspondence Address:
Kavita Raja
Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram - 695 011, Kerala
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jacm.jacm_9_22

We report a rare occurrence of central nervous system hydatid disease involving the occipital lobe caused by Echinococcus multilocularis in an immunocompetent rural tribal man. A 40-year-old man presented with gradual onset of headache for 6-month duration with associated seizures and giddiness. Neurological examination revealed cerebellar signs with visual field defect. Magnetic resonance imaging revealed a multilobulated cystic lesion with membranous septations and peri-lesional oedema involving the left occipital lobe. Wet mount examination of the aspirated cystic fluid showed multiple daughter cysts and hooklets with histopathological examination showing features suggestive of hydatid disease. The identification of the causative organism was confirmed as E. multilocularis by conventional polymerase chain reaction. The patient's condition improved during the post-operative period and was discharged 2 days later, on oral albendazole for 3 months. At 2 years follow-up, the patient neurological symptoms have recovered with minimal visual field defect.

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