First Case of Human Cerebral Taenia martis Cysticercosis

Abstract

Taenia martis is a tapeworm affecting mustelids, with rodents serving as intermediate hosts. The larval stage (cysticercus) has been found before only rarely in humans or primates. We hereby describe a case of cerebral T. martis cysticercosis in a French immunocompetent patient, confirmed by DNA analyses of biopsy material. CASE REPORT In January 2012, a 44-year-old woman with no significant medical history except Verneuil's disease was admitted to the Strasbourg University Hospital for right hemiparesis and aphasia. Cerebral magnetic resonance imaging (MRI) revealed fluid attenuated inversion recovery (FLAIR) and diffusion signal abnormalities in a small area of the left temporal lobe cortex, associated with leptomeningeal gadolinium-based enhancement in the depth of the adjacent sulcus ( Fig. 1 and 2). On examination, the patient was found to have a temperature of 38.5°C. She reported no travel history outside Europe and presented no immunosuppression. Meningoencephalitis was suspected, and the first examination of the cerebrospinal fluid (CSF) revealed lymphocytic pleocytosis, increased protein levels, and normal glucose concentration. Bacterial antigen detection in CSF was negative, as were CSF bacterial and fungal cultures. Acyclovir, cefotaxime, and amoxicillin were initiated. Five days later, a second lumbar puncture revealed 790 leukocytes/mm 3 (70% lymphocytes, 30% eosinophils) and oligoclonal immunoglobulin bands.Due to the eosinophilia, a complementary serological investigation was performed. Serology was weakly positive (1:60) for Taenia solium using T. solium antigens and immunofluorescence and negative for Echinococcus granulosus using Western blotting with Echinococcus sp. antigens (LDBIO Diagnostics, Lyon, France), Echinococcus multilocularis using enzyme-linked immunosorbent assay (ELISA) with Em2ϩ antigens, (Bordier Affinity Products SA, Crissier, Switzerland), Taenia saginata using T. saginata antigens and immunofluorescence, Schistosoma mansoni using ELISA with S. mansoni antigens (Bordier Affinity Products SA), Trichinella spiralis using ELISA with T. spiralis antigens (LDBIO Diagnostics), and Strongyloides stercoralis using ELISA with Strongyloides ratti antigens (Bordier Affinity Products SA). Stool examinations were negative for parasites. The patient fully recovered the following week. She was readmitted in May 2012 after another episode of aphasia. Cerebral MRI was then performed again, displaying a ring-enhancing lesion along with a small enhancing nodule attached to its border, associated with significant perilesional edema, in the same cortical area as that recorded on the first MRI.Despite MRI revealing no evidence of neoangiogenesis, due to the cerebral blood volume being diminished, there were no clinical features that enabled the distinction from an inflammatory process due to either unknown infection or tumor, such as a glioblastoma or metastatic process. Surgical exeresis of the parasitic mass was performed. The pathological examination demonstrated no signs of a tumoral proces...

Detection of taeniid ( Taenia spp., Echinococcus spp.) eggs contaminating vegetables and fruits sold in European markets and the risk for metacestode infections in captive primates

“…Rare cases of carnivore-transmitted cysticercosis caused by, for example, T. crassiceps ( Heldwein et al., 2006 , Flammer et al., 2014 ) and T. martis ( Brunet et al., 2015 , Eberwei et al., 2013 ), have been documented in people in Europe. Furthermore, several lethal T. martis ( Brunet et al., 2014 , De Liberato et al., 2014 ) and T. crassiceps infections were reported recently for lemurs in zoos ( Luzon et al., 2010 ).…”

Molecular Diagnosis of Human Taenia martis Eye Infection

“…8 Human infection with T. martis, where the human serves as dead-end intermediate host, is very rarely seen and only two cases have been reported so far. 4,5 In 2010, the first described human infection with larval T. martis had occurred in a 43-year-old woman living in a small village in southwest Germany. 4 The patient had complained of flashing light sensations in her left eye, and a T. martis larva had been found subretinally similar to our case.…”

“…The second human infection with T. martis had been diagnosed in 2012 in a 44-year-old woman in eastern France. 5 A single lesion had developed in the left temporal lobe of the brain, causing aphasia and hemiparesis. The parasite had been removed surgically and an oral antiparasitic regimen with albendazole and praziquantel had been administered, leading to full recovery.…”

“…1 However, other Taenia species with different reservoirs and epidemiology, such as Taenia crassiceps and Taenia martis, may also cause human cysticercosis, but much more rarely. [2][3][4][5] The larval stages share a highly similar morphology, and they might be virtually indistinguishable on histological sections. 6 Still, for prognosis, prevention, and detection of parasite reservoirs, the species responsible for human disease should be determined.…”

Cerebral Neurocysticercosis due to Taenia martis, the Third Species That Needs Attention

“…Brunet et al reported neurocysticercosis due to Taenia martis in an immunocompromised host. In fact, Taenia martis has been described in human beings for a few years but not in brain (3). The new species cerebral neurocysticercosis is an actual challenge.…”