-Case Reports-

A Case of Metagonimiasis Complicated with Multiple Intracerebral Hemorrhages and Diabetes Mellitus

Shoko Merrit Yamada¹, Shokei Yamada¹, Hitomi Takada², Yayoi Carol Hoshiai³ and Shotetsu Yamada⁴

¹Department of Neurosurgery, Yamada Hospital, Shizuoka
²Department of Internal Medicine, Yamada Hospital, Shizuoka
³Department of Ophthalmology, Yamada Hospital, Shizuoka
⁴Department of General Surgery, Yamada Hospital, Shizuoka

Metagonimiasis yokogawai is an unusual intestinal parasitic disease caused by metacercariae of Metagonimus yokogawai. The first clinical manifestations of this disease do not always correlate with gastrointestinal signs. A 61-year-old man with left hemiparesis and disorientation was admitted to our hospital because of atypical nonhypertensive multiple intracerebral hemorrhages, which were conservatively treated. The patient was discharged from our hospital after 2 months without any neurological deficits; however, he was readmitted owing to a body temperature higher than 38°C for nearly 2 weeks. Examination of stool revealed eggs of M. yokogawai, and the body temperature returned to normal after administration of praziquantel. Furthermore, the control of the patient's diabetes mellitus (DM) markedly improved after the treatment, although the patient had had DM for more than 2 years. We conclude that DM is a chronic sign of metagonimiasis in carriers and that intracerebral hemorrhage might be an acute sign in the aggravated phase of the disease.

J Nippon Med Sch 2008; 75: 32-35

Keywords
diabetes mellitus, intracerebral hemorrhage, metagonimiasis, parasite, trematode

Correspondence to
Shoko Merrit Yamada, MD, Department of Neurosurgery, Yamada Hospital, 6 Hamada-cho, Shimizu-ku, Shizuoka, 424-0834, Japan
merrityamada@hotmail.co.jp

Received, July 12, 2007
Accepted, October 17, 2007