Case report: A rarely seen cause of brain abscess - neurotoxocariasis

Background: Toxocariasis is associated with three syndromes in human beings which are visceral larva migrans, ocular larva migrans and covert toxocariasis. Although neurotoxocariasis is defined as the fourth syndrome of toxocariasis, it is usually considered as a neurological disease which is usually concomitant with visceral larva migrans. In this abstract we report a case of brain abcess caused by toxocariasis. Methods & Materials: A 56 years-old female patient admitted at our hospital with headache, pain referring to right side of her face and teeth, numbness of forth and fifth finger of her right hand. Cranial diffusion weighted, dynamic magnetic resonance imaging (MRI) revealed a few nonspesific intensities at supratentorial white matter, and an approximately 13x12mm lesion without contrast enhancement which had a significant edema around the whitematter in the left frontal cortex. Histologic examination after stereotactic biopsy of the lesion revealed diffuse histiocyte infiltration in histological examination. Results: A spesific agent could not be detected in histochemical examination.Western-blot test toxocariasis in serumand CSFwere positive. She was transferred to the infectious diseases and clinical microbiology clinic.Albendazole 400mg q12h was started. A total of onemonthduration for albendazole treatmentwasplanned after regression of the cranial MRI findings on the 14th day of therapy. The patient is recalled for cranial MRI control three months later. However, we found out that she continued albendazole for three months. Compared to the previous MRI, there were two stabilized T2A hyperintense lesions in left cranial hemisphere and minimally regressed lesions at the level of left frontal centrum semi-ovale. There was no relapse after six month follow up. The Conclusion: The presented case suggests that although rarely neurotoxocariasismaybe encountered in the etiology of encephalitis/brain abcess. The patient was successfully treated with albendazole. To our knowledge this is the first reported case of neurotoxocariasis n Turkey.