A Case Report of Recurrent Cerebral Hydatid Cyst; Interaction between Phenytoin and Albendazole

Hydatidosis is possible in all organs. However, brain involvement is only observed in only 1-2% of patients and is very rare. Common symptoms of brain involvement include headache, vomiting, seizures, behavioral disorders, or unilateral symptoms such as paralysis of one half of the body. Here we present a patient with cerebral hydatidosis that has recurred due to drug interactions between phenytoin and albendazole.

CASE REPORT: 

The patient is a 19 -year- old man with a history of cerebral hydatidosis who underwent two surgeries with complaints of generalized tonic-clonic seizures. CT scan of the brain showed a lobule cyst with internal septa in the right hemisphere of the brain with an adjacent lesion that has wall calcification, suggesting cerebral hydatidosis. To control the patient s seizures, sodium valproate was substituted for phenytoin and oral albendazole was recommended in consultation with the Infectious Diseases Service. The patient was discharged after five days in good general condition.

According to this case, concomitant use of anticonvulsant drugs including phenytoin, phenobarbital, and carbamazepine with albendazole has been reported to reduce plasma levels of albendazole and reduce its efficacy. Therefore, to control seizures in patients with cerebral hydatidosis treated with albendazole, it is better to use other anticonvulsant drugs.