Cerebral Paragonimiasis with Arteriovenous Malformation in a Child: A Case Report

Abstract

Cerebral paragonimiasis with coexisting arteriovenous malformation is extremely rare. A 6-year-old girl was admitted to hospital due to confusion and frequent vomiting for 20 h. The physical examination was normal except for a slow light reflex on the left pupil. Blood tests showed a high white blood cell count and a normal eosinophils count. The head computed tomography (CT), advanced head CT scan and vascular reconstruction showed a linear fracture on the left harnpan, uneven thickness in the abnormal blood vessels of the left parietal region with a mixed local high-density area with clear edge. Arteriovenous malformation was diagnosed, and a vascular malformation resection was performed. Repeat blood tests showed an increased eosinophils count and the presence of Paragonimus-specific IgG antibodies. The patient was subsequently diagnosed with cerebral paragonimiasis and was given oral praziquantel as 75 mg /kg/day in three divided doses with an interval of four days. After two courses of treatment, the patient was discharged. Follow-up after six months showed negative Paragonimus-specific IgG antibodies titers. Vascular malformation resection combined with oral praziquantel administration provided a satisfactory therapeutic effect for cerebral paragonimiasis with coexisting arteriovenous malformation.