Solitary Cysticercosis as a rare differential diagnosis for Acute Calf Pain : A Case Report

Raghav Arora; Pankaj Mahindra

Volume : IX, Issue : IV, April - 2020

Solitary Cysticercosis as a rare differential diagnosis for Acute Calf Pain : A Case Report

Raghav Arora, Pankaj Mahindra

Abstract :

A 27 years old female presented with progressively increasing calf pain and swelling with no history of trauma, diabetes mellitus, fever or prolonged bed rest. On examination there was diffuse swelling over the calf without any redness and local temperature was normal. Calf was soft but tender. Both DP and PTA were palpable. Various differential diagnosis included deep vein thrombosis, cellulitis, pyomyositis, arterial aneurysm, epidermoid cysts, neurofiomas, sarcoma, myxoma. Venous and Arterial Colour Doppler showed no evidence of deep venous thrombosis or aneurysm. Ultrasound revealed a cystic lesion with small echogenic areas. MRI showed a well defined thick walled solitary cystic lesion with scolex, appe� hyperintense on T2 images and isointense on T1 images in the soleus muscle with perilesional edema. ELISA for IgG anti– bodies against T. solium was positive. Solitary intramuscular cysticercosis of soleus muscle is very rare and maybe asymptomatic. Clinicians in endemic areas should keep high level of suspicion for this condition to avoid misdiagnosis and wrong treatment. MRI alongwith serology are useful non–invasive tools to confirm the diagnosis. Isolated intramuscular painful swellings should be evaluated for cysticercosis.