Encephalopathy in a patient with loiasis treated with albendazole: A case report |
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| Affiliation: | 1. McMaster Medical Centre, Hamilton, Ontario, Canada;2. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada;3. Tropical Disease Unit, Toronto General Hospital, University of Toronto, Canada;1. Laboratory for Drugs and Molecular Diagnostics Research (ANDI Centre of Excellence for Onchocerciasis Drug Research), Biotechnology Unit, University of Buea, Cameroon;2. Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon;3. Laboratory of Endocrinology and Radioelements, Institute of Medical Research and Medicinal Plant Studies (IMPM), P.O. Box 8013, Yaounde, Cameroon;4. Department of Biomedical Sciences, Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bambili, Cameroon;1. Center for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy;2. Prevention Department, ULSS 20 Verona, Verona, Italy;3. Department of Infectious Diseases, Hospital of Trieste, Trieste, Italy;4. Institut de Recherche pour le Développement (IRD), Montpellier, France;1. Research Institute for Development, University of Montpellier, Montpellier 34394, France;1. Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar, Germany;2. Paediatric Oncology and Haematology, Children''s Hospital, Saarland University Medical Center, Homburg/Saar, Germany;3. Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany;1. Department of Parasitology Mycology, Faculty of Medicine, Université des Sciences de la Santé, BP 4009 Libreville, Gabon;2. Department of Biochemistry, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon |
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| Abstract: | ![]()
BackgroundLoiasis is a vector-borne parasitic infection endemic across many areas of Central and West Africa. Its treatment is tricky due to the risk of serious neurologic adverse events occurring after the administration of microfilaricidal drugs, like diethylcarbamazine or ivermectin, in subjects with high pre-treatment microfilarial load. Albendazole is currently recommended to slowly reduce microfilaremia before curative regimen is prescribed.Case presentationWe report the case of a 25-year-old man from Guinea-Conakry who was incidentally diagnosed with highly microfilaremic Loa loa infection. A three weeks regimen of albendazole was prescribed. Minor neurologic side effects occurred after two weeks of administration, while serious encephalopathy developed one week later. Clinical and electroencephalographic features of the patient resembled those of an immune-mediated encephalitis. After exclusion of other causes of encephalopathy, treatment-related Loa loa encephalopathy induced by albendazole was suspected. Corticosteroid treatment was administered and the patient recovered.DiscussionOur case confirms that Loa loa treatment-related encephalopathy may occur even during albendazole treatment. The clinical and electroencephalographic similarities between Loa loa albendazole-related encephalopathy and immune-mediated encephalitis suggest the possibility of an underlying inflammation-based pathogenesis. Although corticosteroid administration is not recommended in Loa loa ivermectin-induced encephalopathy, in this case of Loa loa albendazole-induced encephalopathy it may have played a therapeutic role. |
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