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Pathology of CNS parasitic infections.
[dracunculiasis]
Parasitic
infections
of
the
central
nervous
system
(
CNS
)
include
two
broad
categories
of
infectious
organisms
:
single
-celled
protozoa
and
multicellular
metazoa
.
The
protozoal
infections
include
malaria
,
American
trypanosomiasis
,
human
African
trypanosomiasis
,
toxoplasmosis
,
amebiasis
,
microsporidiasis
,
and
leishmaniasis
.
The
metazoal
infections
are
grouped
into
flatworms
,
which
include
trematoda
and
cestoda
,
and
roundworms
or
nematoda
.
Trematoda
infections
include
schistosomiasis
and
paragonimiasis
.
Cestoda
infections
include
cysticercosis
,
coenurosis
,
hydatidosis
,
and
sparganosis
.
Nematoda
infections
include
gnathostomiasis
,
angiostrongyliasis
,
toxocariasis
,
strongyloidiasis
,
filariasis
,
baylisascariasis
,
dracunculiasis
,
micronemiasis
,
and
lagochilascariasis
.
The
most
common
route
of
CNS
invasion
is
through
the
blood
.
In
some
cases
,
the
parasite
invades
the
olfactory
neuroepithelium
in
the
nasal
mucosa
and
penetrates
the
brain
via
the
subarachnoid
space
or
reaches
the
CNS
through
neural
foramina
of
the
skull
base
around
the
cranial
nerves
or
vessels
.
The
neuropathological
changes
vary
greatly
,
depending
on
the
type
and
size
of
the
parasite
,
geographical
strain
variations
in
parasitic
virulence
,
immune
evasion
by
the
parasite
,
and
differences
in
host
immune
response
.
Congestion
of
the
leptomeninges
,
cerebral
edema
,
hemorrhage
,
thrombosis
,
vasculitis
,
necrosis
,
calcification
,
abscesses
,
meningeal
and
perivascular
polymorphonuclear
and
mononuclear
inflammatory
infiltrate
,
microglial
nodules
,
gliosis
,
granulomas
,
and
fibrosis
can
be
found
affecting
isolated
or
multiple
regions
of
the
CNS
,
or
even
diffusely
spread
.
Some
infections
may
be
present
as
an
expanding
mass
lesion
.
The
parasites
can
be
identified
by
conventional
histology
,
immunohistochemistry
,
in
situ
hybridization
,
and
PCR
.
Diseases
Validation
Diseases presenting
"common route"
symptom
dracunculiasis
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