Albendazole
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Unmasking of neurocysticercosis: case report A 32-year-old man with occult neurocysticercosis experienced unmasking of the disease after treatment with albendazole. The man presented with a first seizure. He spontaneously recovered, but developed severe headache and confusion over the next 2 days. A cranial CT scan showed left frontal lobe oedema, and CSF examination revealed the following: protein 0.55 g/L, and WBC count 30/mL with 26 lymphocytes and 4 neutrophils. On MRI scan, a single ring-enhancing lesion with surrounding oedema was evident in his frontal lobe. Findings were suggestive of a degenerating cystericercal cyst, and a cysticercosis immunoblot was positive. It was then revealed that his wife had given him a single albendazole 400mg tablet two days before symptom onset; she reported using the drug annually as deworming therapy. The man started receiving antiepileptic therapy, and then received a 14-day course of albendazole 400mg twice daily plus corticosteroids. His brain lesions had completely resolved on repeat MRI 15 months later; he had no further seizures and stopped antiepileptic therapy. Author comment: "[T]reatment of taeniasis or other parasitic infections with albendazole may lead to unforeseen treatment of neurocysticercosis. Without concomitant steroid and anticonvulsant therapy this may lead to neurological symptoms as the larvae dies and an inflammatory reaction occurs." Lillie P, et al. Empiric albendazole therapy and new onset seizures - A cautionary note. Journal of Infection 60: 403-404, No. 5, May 2010. Available from: URL: 803029780 http://dx.doi.org/10.1016/j.jinf.2010.02.004 - United Kingdom
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Reactions 14 Aug 2010 No. 1314
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