Cerebral sparganosis caused by spirometra sp.: A case report.

Cerebral sparganosis is a rare parasitic infection caused by plerocercoid larvae of the genus Spirometra. Due to its nonspecific clinical manifestations, diagnosis remains challenging in clinical practice. Here, we report a case of a 72-year-old female who presented with intermittent fever and migratory intracranial mass lesions over a seven-year period, accompanied by progressive cognitive decline and right homonymous hemianopia. Metagenomic next-generation sequencing (mNGS) analysis of cerebrospinal fluid identified Spirometra sp. The diagnosis was further confirmed through brain lesion biopsy and tissue mNGS analysis. Following treatment with praziquantel and albendazole, the patient showed clinical improvement with no evidence of recurrence during 1-year follow-up. This case report highlights the diagnostic value of mNGS in identifying rare parasitic infections, particularly in cases of cerebral sparganosis where clinical presentation may be non-specific.