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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:446-449, March 2004
© 2004 American Society of Neuroradiology

Case Report
SPINE

MR Imaging Findings in Cerebrospinal Gnathostomiasis

Kittisak Sawanyawisuth^a, Somsak Tiamkao^a, Jaturat Kanpittaya^b, Paron Dekumyoy^c and Suthipun Jitpimolmard^a

^a Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
^b Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
^c Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

Address correspondence to Dr. Kittisak Sawanyawisuth, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 40002

Summary: Human gnathostomiasis is an infection caused mainly by Gnathostoma spinigerum, a nematode. Infected humans can present with various clinical manifestations. Serology is the criterion standard for diagnosing gnathostomiasis, whereas MR imaging represents a complementary tool for assessing severity and extent of disease. We report two definite cases of gnathostomiasis that were confirmed by the immunoblotting technique. MR imaging of the cervical cords showed cord enlargement and diffuse high signal intensity, mainly of the gray-white matter regions. MR imaging of the brain showed hemorrhagic tract and scattered deep intracerebral hemorrhage with diffuse, fuzzy white matter lesions with nodular enhancement. Severe gnathostomiasis was unresponsive to treatment.

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