title: Cerebral paragonimiasis: an unusual manifestation of a rare parasitic infection.
abstract: BACKGROUND
  Paragonimiasis is a parasitic disease that typically produces a subacute to chronic inflammatory disease of the lung. Although rare in the United States, paragonimiasis is sporadically observed in the immigrant population. Rarely, paragonimiasis can affect the nervous system. This infection is even more unusual in the pediatric population, and therefore can be challenging to diagnose.
  
  
  METHODS
  Here we present a child with cerebral paragonimiasis. She presented with new onset seizures in the setting of a febrile illness. Magnetic resonance imaging of the brain with contrast revealed a ring-enhancing lesion within the right frontal lobe and a second lesion in the left parietal lobe extending from the cortex to the centrum semiovale. Extensive evaluation including stool ova and parasite analysis confirmed the diagnosis of Paragonimus westermani. She was treated with praziquantel and prednisone and improved both clinically and radiographically.
  
  
  CONCLUSIONS
  Cerebral paragonimiasis is diagnosable and treatable and therefore is important to consider in the differential of immigrants presenting with cavitary lung lesions and central nervous system findings.
authors.affiliation: Department of Neurology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, New York.
authors.forename: Supriya
authors.initials: S
authors.lastname: Kohli
authors.affiliation: Department of Neurology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, New York. Electronic address: ofarooq3@buffalo.edu.
authors.forename: Osman
authors.initials: O
authors.lastname: Farooq
authors.affiliation: Department of Neurology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, New York.
authors.forename: Ronak B
authors.initials: RB
authors.lastname: Jani
authors.affiliation: Department of Neurology, University at Buffalo School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, New York.
authors.forename: Gil I
authors.initials: GI
authors.lastname: Wolfe
mesh_terms: D020807:Central Nervous System Parasitic Infections / Q000150:complications*; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010237:Paragonimiasis / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: cerebral; paragonimus; parasite; pediatric