关键词: 神经囊尾蚴病, 诊断, 治疗, 阿苯达唑, 吡喹酮

Abstract:

A 8-year-old male Tibetan child was admitted to the West China Second Hospital of Sichuan University on October 25, 2024, due to intermittent fever, headache and vomiting. The patient had long resided in Mangkang County, Changdu City, Xizang Autonomous Region, with cattle and sheep raised in his family, and he had a history of consuming raw beef and mutton. Physical examination revealed a palpable mass near the elbow joint on the medial side of the left upper arm, measuring 2 cm × 1.5 cm with no significant tenderness. Serological tests showed positive IgG antibodies against Echinococcus, and liver function tests indicated alanine aminotransferase at 59 U/L and aspartate aminotransferase at 58 U/L. Respiratory multiplex pathogen nucleic acid assay tested positive for rhinovirus. Tapeworm eggs were identified in stool samples on October 29, October 30, and November 6. Head MRI scans (plain scan + contrast enhancement) displayed multiple space-occupying lesions in the bilateral cerebral hemispheres, presenting as circle-like long T1 and long T2 signal shadows, and superficial ultrasound of the left upper arm showed a cystic-solid mass within the muscular layer of biceps brachii. On November 1, 2024, a subcutaneous and intramuscular nodule resection was performed in the left upper arm, and pathological biopsy identified parasites in the muscle and fibrous tissues, which confirmed the diagnosis of neurocysticercosis, subcutaneous, and muscular cysticercosis. The child was given anti-parasitic treatment with albendazole [15 mg/(kg·d)] and praziquantel [(50 mg/(kg·d)] for 10 days, followed by anti-inflammatory therapy with dexamethasone. He had improvements and was then discharged from hospital. After discontinuation for 3 days, drug administration was resumed for another 10 days. Follow-up calls at 3 and 6 months post-discharge showed no significant abnormalities.

Key words: Neurocysticercosis, Diagnosis, Treatment, Albendazole, Praziquantel