Hydatid brain cyst: A delayed diagnosis in a rural setting during COVID-19

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Hydatid brain cyst: A delayed diagnosis in a rural setting during COVID-19


JournalSouth African Medical Journal
Article typeJournal research article – Case report / series
Publication date – Nov – 2021
Authors – C J Opperman, J M N Enslin, J Nuttall, A J Brink, S P da Fonseca, H D Tootla
KeywordsAlbendazole, Brain cyst, covid-19, Echinococcosis, Echinococcus, Hydatid, Praziquantel, SARS-CoV-2, seizures
Open access – Yes
SpecialityNeurosurgery
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on November 14, 2021 at 1:26 am
Abstract:

A previously healthy 10-year-old girl, living in a sheep-farming community in South Africa with exposure to dogs, presented to her local hospital with generalised tonic-clonic seizures. The initial clinical assessment and laboratory work-up were unremarkable. When she presented with further seizures 6 months later, attempts to arrange neuroimaging and specialist assessment were unsuccessful owing to restrictions on routine healthcare services during the SARS-CoV-2 nationwide lockdown. Subsequently, 11 months after her first presentation, she developed focal neurological signs suggestive of raised intracranial pressure. A brain computed tomography scan revealed a left-sided cerebral cyst and imminent tonsillar herniation. An emergency burr-hole procedure was performed to relieve the raised intracranial pressure, followed by definitive neurosurgical excision of cysts. Hydatid protoscolices and hooklets were seen on microscopy of cyst fluid, and treatment with albendazole and praziquantel was initiated. While her infection was treated successfully, long-term sequelae including permanent blindness and hemiparesis could potentially have been prevented with early neuroimaging and surgical intervention.

OSI Number – 21341

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