Misdiagnosed behavior change revealing fatal primitive intra-cerebral echinococcosis

Abstract

Central nervous system involvement in hydatidosis is rare compared to other somatic localizations: 1-5%. It is schematically divided into two major types: cerebral involvement and spinal involvement. The brain is a rare localization of hydatid cyst accounting for only 2% of all hydatid disease. The psychiatric manifestations revealing cerebral hydatidosis remain exceptional and often unrecognized and neglected by practitioners despite their potential severity. We report two original observations of fatal cerebral hydatidosis revealed by behavior change (psychomotor agitation, aggressiveness, persecutory delusion, and auditory and visual hallucinations) insufficiently explored in two women aged 45 and 17. The possibility of cerebral hydatidosis must always be evoked in front of any psychiatric symptomatology that remains unexplained in endemic areas for echinococcosis.