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Background
Parasitic infections have become more common worldwide in large part due to the increase in frequency and ease of international tourism and emigration. A similar phenomenon can be seen with various parasitic and nonparasitic vector-borne infections, although with the additional impact of climate change expanding the geographic distribution of the vectors and, subsequently, the diseases they transmit. As these infections emerge in unexpected locations, and especially if patients fail to disclose or clinicians fail to make the connection with a history of travel or an encounter with a relevant vector, they can present as medical mysteries resulting in delays in diagnosis and treatment. With the appropriate imaging studies and knowledge and recognition of the salient findings, radiologists have the potential to play a major role in making the diagnosis.

Educational Goals / Teaching Points
This exhibit aims to familiarize the radiologist with the variety of parasitic and vector-borne diseases which infect humans, focusing on disease manifestations within the head and neck. This will include a brief introduction to the epidemiology of these conditions, and a broader look at the clinical presentations and medical sequelae/complications of these infections as they pertain to neuroradiology and head/neck imaging. The exhibit will provide an array of case examples to demonstrate the imaging features associated with both acute and chronic, and common and uncommon sequelae of vector-borne and parasitic infections across multiple imaging modalities. It will also provide a brief overview of management and treatment of these infections.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review parasitic and vector-borne infections resulting in disease manifestations within the head and neck, including protozoan infections (e.g., Chagas disease, leishmaniasis, cerebral malaria, toxoplasmosis), helminthic infections (e.g., cystic echinococcosis, cysticercosis), and vector-transmitted bacterial (e.g., Lyme disease) and viral infections (e.g., Eastern equine encephalitis, Powassan virus). It will provide a multimodality review of imaging findings, although primarily focusing on CT and MRI. It will review specific (e.g., multiloculated cysts characteristic of cystic echinococcosis) and nonspecific (e.g., mosquito- or tick-borne viral encephalitis) imaging findings, as well as common (e.g., mucocutaneous leishmaniasis, orbital cysticercosis) and uncommon sequelae (e.g., neurological manifestations of Chagas) of these diseases which can be appreciated on imaging studies of the head and neck.

Conclusion
Vector-borne and parasitic infections are being seen more frequently all over the world, and increasingly often in unexpected situations. A radiologist who is familiar with these infections and their sequelae has the potential to be the first to suggest the diagnosis.