Anu Davaasuren1, Abmed Davaajav2, Baigalmaa Ukhnaa3, Altantsetseg Purvee4, Saraa Unurkhaan5, Amartuvshin Luvsan6, Jenae E Logan7, Akira Ito8. 1. Laboratory of Parasitology, National Center for Communicable Diseases, Ulaanbaatar, Mongolia. Electronic address: davaasuren_a@ymail.com. 2. Laboratory of Parasitology, National Center for Communicable Diseases, Ulaanbaatar, Mongolia. Electronic address: abmed99@yahoo.com. 3. Department of Radiology, Luxmed Hospital, Ulaanbaatar, Mongolia. Electronic address: ubaigalmaa@yahoo.com. 4. Neurology Center, The State Third Central Hospital, Ulaanbaatar, Mongolia. Electronic address: p_altaa06@yahoo.com. 5. Neurology Center, The State Third Central Hospital, Ulaanbaatar, Mongolia. Electronic address: saraan_he@yahoo.com. 6. Department of Radiology, The State Third Central Hospital, Ulaanbaatar, Mongolia. Electronic address: amar_g76@yahoo.com. 7. Division of Infectious Disease, School of Medicine and Global Health Institute, Duke University, North Carolina, USA. Electronic address: jenae.logan@duke.edu. 8. Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan. Electronic address: akiraito@asahikawa-med.ac.jp.
Abstract
BACKGROUND: Neurocysticercosis (NCC) of Taenia solium has never been reported in Mongolia. A Mongolian traveler who visited China and India presented with epileptic seizures after his return to Mongolia. Magnetic resonance imaging showed multiple ring enhancing lesions with edema surrounding several lesions in his brain that were initially diagnosed to be viral encephalitis or NCC. METHODS: Serology for cysticercosis using diagnostic antigens partially purified by cation-exchange chromatography and chimeric recombinant antigens and DNA analysis of a proglottid found in the patient's stool were applied for differential diagnosis. RESULTS: Serology showed strong positivity for NCC, and mitochondrial cox1 gene analysis revealed Indian but not Chinese haplotype of T. solium. CONCLUSION: This NCC case was considered to be caused by eggs released from adult tapeworm(s) established after eating uncooked or undercooked pork contaminated with cysticerci during his stay in India. This is a case report of taeniasis and secondary NCC associated with travel to India with an updated review of NCC in Asia. Molecular tracking of the specimen is highly informative as a way to identify where the infection was acquired.
BACKGROUND:Neurocysticercosis (NCC) of Taenia solium has never been reported in Mongolia. A Mongolian traveler who visited China and India presented with epilepticseizures after his return to Mongolia. Magnetic resonance imaging showed multiple ring enhancing lesions with edema surrounding several lesions in his brain that were initially diagnosed to be viral encephalitis or NCC. METHODS: Serology for cysticercosis using diagnostic antigens partially purified by cation-exchange chromatography and chimeric recombinant antigens and DNA analysis of a proglottid found in the patient's stool were applied for differential diagnosis. RESULTS: Serology showed strong positivity for NCC, and mitochondrial cox1 gene analysis revealed Indian but not Chinese haplotype of T. solium. CONCLUSION: This NCC case was considered to be caused by eggs released from adult tapeworm(s) established after eating uncooked or undercooked pork contaminated with cysticerci during his stay in India. This is a case report of taeniasis and secondary NCC associated with travel to India with an updated review of NCC in Asia. Molecular tracking of the specimen is highly informative as a way to identify where the infection was acquired.
Authors: Alfonso J Rodríguez-Morales; María Camila Yepes-Echeverri; Wilmer F Acevedo-Mendoza; Hamilton A Marín-Rincón; Carlos Culquichicón; Esteban Parra-Valencia; Jaime A Cardona-Ospina; Ana Flisser Journal: Travel Med Infect Dis Date: 2017-12-27 Impact factor: 6.211