Diagnosis and Treatment of Hemorrhagic Cerebral Paragonimiasis: Three Case Reports and Literature Review

Özet

AIM: To investigate the clinical manifestations and radiologic characteristics in diagnosing and treating hemorrhagic cerebralparagonimiasis.MATERIAL and METHODS: The study retrospectively analyzed the data of three cases of hemorrhagic paragonimiasis whoreceived treatment in the hospital from January 2014 to March 2017. All three patients were diagnosed with paragonimiasis bypositive detection of paragonimiasis antibody. Based on the imaging data, the disease was confirmed as hemorrhagic cerebralparagonimiasis. One of the three patients was treated with oral praziquantel alone, one with praziquantel and thoracentesis, andone with praziquantel in combination with closed thoracic drainage and craniotomy.RESULTS: All the lesions disappeared after computed tomography scan during the follow-up. Two of the three patients had nodysneuria, and one had mild dysneuria.CONCLUSION: Hemorrhagic cerebral paragonimiasis should be diagnosed as early as possible using antibodies againstparagonimiasis for patients with unexplained intracerebral hemorrhage, especially young patients with atypical imaging findingsand multiple systemic lesions. It is possible to avoid craniotomy and improve the cure rate by the early, full-dose, and sufficientcourse of anti-parasitic treatment.