Conflicts of Interests:The Authors declare that there are no competing interests. This article is licensed under a Commons Attribution Non-Commercial 4.0 LicenseABSTRACT Cysticercosis is triggered by infection with the larval form of the tapeworm Taenia solium. The usual sites for the development of cyscticerci are the central nervous system (neurocysticercosis -NCC), subcutaneous tissue, skeletal muscle, heart muscle, and the eye. Ocular cysticercosis is caused by the growth of the larvae within ocular tissues. The extraocular muscles form is the most common type of orbital cysticercosis. We report a case of a patient admitted with seizures secondary to NCC, who developed ocular symptoms after starting combined treatment with albendazole, praziquantel and dexamethasone. The investigation revealed a cystic lesion in the lateral rectus muscle. LEARNING POINTS• Neurocysticercosis (NCC) is the main cause of epilepsy in someone coming from an endemic area; therefore, it is imperative to have a high index of suspicion.• Ocular cysticercosis can present at the time of diagnosis or can be triggered by the cysticidal treatment.• Before starting cysticidal treatment, systemic corticosteroid should be used in order to reduce the inflammatory response secondary to the release of toxins following the death of the parasite. KEYWORDS Neurocysticercosis (NCC), Taenia solium, orbit, extraocular muscles, dexamethasone CASE DESCRIPTION We present a 38-year-old male from Cape Verde, resident in Portugal. His last trip to Cape Verde had been two years previously. He has a history of alcohol and tobacco dependence. Six years previously, he had been admitted to the emergency department after collapsing. A cranial computed tomography (CT) scan revealed multiple punctiform calcifications in both cerebral hemispheres and in the cerebellum, surrounded by a small cyst and with an eccentric position, suggestive of parasitic infestation -cysticercosis. On the infectious diseases ward, treatment began with albendazole and dexamethasone. Beyond cysticidal treatment for NCC, carbamazepine was started as the diagnosis of secondary epilepsy was established. In April 2016, he was admitted again to the Emergency Department after a convulsion, presenting without fever or other neurological symptoms. He had undergone a cranial CT scan (Figs.

Epstein–Barr virus (EBV) is a well-known cause of different types of malignancies particularly Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's lymphomas, and non-Hodgkin's lymphomas including primary central nervous system lymphoma (PCNSL). A higher tendency of malignant transformation associated with EBV has been noticed in immunocompromised patients, such as human immunodeficiency virus (HIV) infected patients. The rapid and effective immune reconstitution is crucial to prevent PCNSL in HIV-positive patients. We present a clinical case of a young patient diagnosed with HIV infection and medicated with antiretroviral therapy (ART) with poor immunological recovery. After two weeks, he developed ventriculoencephalitis, observed in the cranial magnetic resonance imaging (MRI), caused by cytomegalovirus (CMV) and EBV, both with high serum viral load, rapidly evolving to PCNSL. With this unusual clinical case, the authors want to draw attention to the importance of rapid immunological reconstitution in preventing the progression of EBV infection to PCNSL, as well as encouraging the confirmation of the usefulness of early combination of chemotherapy and antiviral therapy, in order to reach a more effective treatment of this herpesvirus infection and associated malignancies.

using Cox regression was used to assess the association of OS and variables including RT, age, and year of diagnosis. Results: 1382 patients diagnosed with TALL were identified. The median age at diagnosis was 9 years. There was a significant increase in the use of RT with 48.1% of patients between 2003 and 2012 receiving RT compared with 35.4% between 1980 and 2002 (P<0.001). Age at diagnosis and sex were not associated with differential use of radiation. On univariate analysis, RT was associated with an improvement in 5-year OS compared with no RT (81.6% vs. 73.7, P<0.001). OS was also improved for patients between 2003 and 2012 compared with 1980 and 2002 (84.8% vs. 69.0%, P<0.001), and age less than 10 years compared with age 10 years or older (80.6% vs. 73.1%, PZ0.001). On multivariate analysis, RT use (HRZ 0.672, PZ0.002), year of diagnosis between 2003 and 2012 (HRZ 0.464, P<0.001), and age at diagnosis <10 years (HRZ 0.635, P<0.001) all independently predicted for improved OS. Conclusion: In contrast to the majority of pediatric malignancies where RT use is decreasing, utilization of RT for TALL has been increasing. RT use is associated with improved OS independent of year of diagnosis and age of the patient. Limitations include the absence of data in the SEER database regarding chemotherapy, RT site, and CNS risk stratification of ALL patients.