Disseminated cysticercosis
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Case presentation: A 49-year-old male refugee from Uganda with a history significant only for hypothyroidism and hypertension presented to the neurology clinic with an eight-year history of seizures. He has not had a seizure for almost two years while on phenobarbital and phenytoin. He denied any history of parasitic infections or any kind of anti-parasitic treatment in the past. He did not have any headache, fever, nausea, or vomiting but reported intermittent episodes of dizziness. Findings on neurological and general physical examination were normal. Laboratory findings were notable for peripheral eosinophilia and thrombocytopenia present for a few months, which resolved in subsequent evaluations. Human immunodeficiency virus 1/2 Antigen/Antibody (HIV 1/2 Ag/Ab) screen was negative. T1-weighted magnetic resonance imaging (MRI) of his brain showed rim-enhancing cystic lesions in the left frontal and right occipital lobes, left parietal, left temporalis muscle, and left trapezius muscle. The parenchymal lesions were partially calcified. Cysticercosis serum antibody immunoglobulin G (IgG) was negative. Confirmatory immunoblot antibody testing offered by the Center for Disease Control and Prevention (CDC) was positive, supporting the diagnosis of disseminated cysticercosis.
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