Misdiagnosed behavior change revealing fatal primitive intra-cerebral echinococcosis

Abstract

Central nervous system involvement in hydatidosis is rare compared to other somatic localizations: 1-5%. It is schematically divided into two major types: cerebral involvement and spinal involvement. The brain is a rare localization of hydatid cyst accounting for only 2% of all hydatid disease. The psychiatric manifestations revealing cerebral hydatidosis remain exceptional and often unrecognized and neglected by practitioners despite their potential severity. We report two original observations of fatal cerebral hydatidosis revealed by behavior change (psychomotor agitation, aggressiveness, persecutory delusion, and auditory and visual hallucinations) insufficiently explored in two women aged 45 and 17. The possibility of cerebral hydatidosis must always be evoked in front of any psychiatric symptomatology that remains unexplained in endemic areas for echinococcosis.

Cerebral hydatidosis: Exceptional and challenging form of neurohydatidosis (Review)

“…Schematically, CNS hydatidosis is divided into two major nosological frameworks: brain and spinal involvement [9,10,14]. The cerebral localization is found in 70% of the cases of CNS hydatidosis and spinal involvement in 30% of the cases [14,15].…”

“…The brain remains an exceptional and unusual localization of human hydatidosis; its prevalence is estimated at 1-2% in large series [9][10][11]13,16]. Likewise, cerebral hydatidosis accounts for only less than 3% of all intracranial expansive processes [16,17].…”

“…It is not different from that of other brain tumors. It depends on the location, size, and number of cysts [9,[11][12][13][14][15][16][17][18][23][24][25][26][27][28].…”

“…Involvement of CNS during human hydatidosis (neurohydatidosis) remains exceptional and often very difficult to diagnose [9,10]. The majority of cases are reported as sporadic observations [9][10][11][12][13]. This location is characterized by its severity, these heavy functional repercussions and can sometimes be fatal [9,10].…”

“…The majority of cases are reported as sporadic observations [9][10][11][12][13]. This location is characterized by its severity, these heavy functional repercussions and can sometimes be fatal [9,10].…”