 |
 |
Image 47: This gentleman from Haiti presented with a grand mal seizure in 2003. The images here led to a fine needle biopsy and the neurosurgeon found the core of the lesion quite difficult to penetrate with the needle. The patient has been seizure free for 3 years on phenytoin or valproic acid and neurologically normal. He has been HIV positive for 10 years and well controlled with intermittent periods of antiretrovirals. What is the diagnosis? |
| May 12, 2003 | May 12, 2003 |
Image 47. This is a cestode of unknown species. The biopsy histology, electron microscopy (see below) and the Western blot were compatible with Taenia solium but the specificity of these examinations is unclear. Frozen biopsy material awaits good PCRs for T. crassiceps and T. multiceps. He was treated with 9 months of albendazole in 2003-4 and the lesion lost its polycystic appearance, but retained the central core of dense material (see below). RC Jung et al described a similar case in the AJTMH 30:620-624; 1981 (reproduced in Clinical Parasitology 9th ed PC Beaver et al 1984, pg 517).
 |
 |
|
 |
| H&E | EM (microtrichs) | 2003 | 2006 |