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PubMed2005

MRI and ultrasound in solitary muscular and soft tissue cysticercosis.

Solitary cysticercosis of muscles and soft tissue is a rare disease and can cause a diagnostic dilemma clinically. We present the MRI and ultrasound findings in six patients with solitary muscular and soft tissue cysticercosis. Five of them had clear cysts that displayed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Four of these cysts had scolices within them. One patient had an ill-defined hyperintense lesion on T2-weighted images without any clear cyst. Ultrasound performed in all patients showed similar findings, with the scolices being more clearly appreciated. MRI and ultrasound are useful in the diagnosis of solitary muscular and soft tissue cysticercosis and they reliably establish the diagnosis when a clear cyst with scolex is seen.

Adolescent↗

PubMed2005

Positive reaction for cysticercosis and multicentric anaplastic oligoastrocytoma.

INTRODUCTION: An unusual case of positive immunological testing for cysticercosis in the cystic fluid obtained from an anaplastic oligoastrocytoma is presented. CASE REPORT: A 15-year-old boy was admitted with multiple brain lesions. The biggest was a cyst with a mural node and neurocysticercosis was suspected. In order to relieve intracranial pressure, the cyst was punctured and the immunological testing for cysticercosis was positive, reinforcing the clinical suspicion and leading to a clinical trial with albendazole and steroids. As the patient deteriorated the cystic lesion was removed and the diagnosis of anaplastic oligoastrocytoma was established. A second lesion was eventually approached and the histopathological diagnosis of both specimens concurred. DISCUSSION: Although some authors believe that chronic inflammatory changes following neurocysticercosis could induce the formation of brain tumors, this association may be a mere coincidence. In our case no clinical evidence of a prior infestation by Cysticercus was found. In fact, an exhaustive examination of the specimens did not reveal any areas of inflammatory reaction. We believe that the similarity of the glioma and cysticercosis antigens may be the cause of the positive reactions in the cystic fluid.

Adolescent↗

PubMed1999

Management of intraocular cysticercosis.

BACKGROUND: A study was carried out to investigate the various posterior segment presentations of intraocular cysticercosis and their management. METHODS: A retrospective study of five consecutive cases of intraocular cysticercosis seen at our institute was done. Pars plana vitreous surgery for removal of intact cysts was done in all cases. RESULTS: Complete removal of the intact cyst through the pars plana route was achieved in all cases. Postoperative periods were uneventful, with visual recovery to 6/9 or better in all cases. CONCLUSIONS: Complete surgical removal of the intact cyst can result in good functional recovery in eyes with intraocular cysticercosis.

Adult↗

PubMed2002

Do interleukin-6 and macrophage-migration inhibitory factor play a role during sex-associated susceptibility in murine cysticercosis?

In murine Taenia crassiceps cysticercosis, females sustain larger intensities of infection than males. However, during chronic infection, this difference disappears and males show a feminization process. To further study the role of two cytokines, interleukin-6 (IL-6) and macrophage-migration inhibitory factor (MIF), known to be involved in immunoendocrinological processes during sex-associated susceptibility in cysticercosis, IL-6 and MIF gene knockout (KO) mice were infected, and the number of parasites and serum sex-steroid levels were measured. Results show that IL-6 and MIF KO mice of both genders infected with T. crassiceps cysticerci harbor similar numbers of parasites, with no change in sex-hormone levels. However, in wild-type strains, females have twice as many parasites as males. At the same time, there is a decrease of 80% in testosterone and dihydrotestosterone serum levels, and a 100-fold increase in the levels of estradiol in infected male mice. These results suggest a role for both IL-6 and MIF genes in sex-associated susceptibility in murine T. crassiceps cysticercosis.

Animals↗

PubMed1990

Serological survey of human cysticercosis in Irianese refugee camps in Papua New Guinea.

In 1984, over 10,000 refugees left the Indonesian province of Irian Jaya, and thus possibly imported Taenia solium taeniasis/cysticercosis into Papua New Guinea, which was believed to be free of T. solium until 1966. In a serological survey carried out in 1986, 50 refugees originating from areas endemic for T. solium and 171 patients from other areas with symptoms suggesting the possibility of cysticercosis were examined. As a sensitive prescreening technique an ELISA was used with a crude antigen extract obtained from T. solium metacestodes of pig origin. Of 221 persons investigated, 79 (36%) were positive in ELISA. For excluding frequently occurring cross-reactions in ELISA, Western-blotting (or EITB, enzyme-linked immunoelectrotransfer blot) was employed. In this test the demonstration of antibody activity to the 26 or the 8 kilodalton band has been proved to be species-specific for T. solium cysticercosis. One from 79 patients positive in ELISA was simultaneously positive (26 and 8 kDa) in Western blot, corresponding to the first case found in Papua New Guinea with a highly probable T. solium cysticercosis. This patient, originating from an endemic area in Irian Jaya, had immigrated into Papua New Guinea in 1980. The present work emphasizes the need for using highly specific immunodiagnostic techniques in seroepidemiology of larval cestode infections. T. solium taeniasis/cysticercosis remains a risk for Papua New Guinea, and refugees originating from endemic areas should be regarded as potential carriers of T. solium.

Animals↗

PubMed1984

Serodiagnosis of human cysticercosis using a chromatofocused antigenic preparation of Taenia solium cysticerci in an enzyme-linked immunosorbent assay (ELISA).

Crude preparations of Taenia solium cysticerci were partially purified by a chromatofocusing procedure to obtain antigenic fractions that were shown to be active in the enzyme-linked immunosorbent assay (ELISA) with known positive cysticercosis sera. Evaluation of this antigen in the ELISA serodiagnosis of human cysticercus infection showed an 80% detection of clinically typical cysticercosis patients from West New Guinea, and gave no false positive results in healthy control subjects from either Papua New Guinea or the USA. Cross-reactivity to sera from a panel of subjects with a variety of other parasitic infections was limited to convalescent sera from individuals with echinococcosis. Seroepidemiological screening of three selected tropical populations verified the presence of human cysticercus infection on Bali (Indonesia) and its absence on Guam (in the Mariana Islands) and on Mota Lava (in the Banks Islands of Vanuatu). The purified cysticercus antigen was more sensitive and more specific than crude cysticercus or whole worm preparations for the serodiagnosis of human cysticercosis.

Antigens↗

PubMed1991

Efficacy of the immunoblot assay for cysticercosis in pigs and modulated expression of distinct IgM/IgG activities to Taenia solium antigens in experimental infections.

A recently invented immunoblot assay for human cysticercosis was evaluated for efficacy in pigs. The test population consists of 45 pigs with parasitologically confirmed cysticercosis, 47 with heterologous infections, 45 SPF or concrete raised control animals. With this group of 137 animals the test performance was 100% sensitive and 100% specific. The antigen-specific responses of immunoglobulin A (IgA), IgG and IgM in four pigs infected with Taenia solium eggs derived from a human were quantified by immunoblot. Antigen-specific activities were observed as early as 1 week postinfection. The first antigen-specific isotypic response was IgM antibodies directed against a glycoprotein at 97 KD (GP97). This activity generally disappeared between the sixth and ninth week postinfection. Between Weeks 5 and 8, IgG activity rose as IgM activity fell. The IgG activity, however, was directed mostly towards GP50 and GP42 antigens. If the same response occurs in people with cysticercosis, identifying specific isotype activity may help to distinguish new infection from old.

Animals↗

PubMed1990

Cysticercosis of the tongue.

Cysticercosis is a condition where man forms the intermediate host for the proglottids of Taenia solium. The common sites of cysticercosis are brain, skeletal muscle and subcutaneous tissues, but they can be found at any site. An unusual case of lingual cysticercosis is being reported.

Child, Preschool↗

PubMed1996

Seroepidemiological survey of Taenia saginata cysticercosis in Kenya.

A sero-epidemiological study of Taenia saginata cysticercosis was carried out to determine the prevalence and distribution of the infection in three provinces of Kenya. Serum samples and meat inspection records were collected from cattle at slaughter at export and district abattoirs. Cattle origin and the presence of T. saginata cysticerci were noted as was the prevalence of other helminths such as Echinococcus granulosus and Fasciola gigantica. Serum samples were screened for circulating parasite antigen using a monoclonal antibody-based enzyme-linked immunosorbent assay (Ag-ELISA) and for ante-parasite antibody by indirect ELISA (Ab-ELISA). Eighty per cent of the sera were collected from cattle from the Rift Valley Province of Kenya. The prevalence of T. saginata cysticercosis and the other helminth infections varied between districts and was particularly high in Narok. Animal husbandry practices in arid areas such as Narok may be particularly conducive to transmission. The potential value of the Ag-ELISA for use in sero-epidemiological studies was verified by this study. It detected at least twice as many cases as T. saginata cysticercosis as meat inspection and, of the three methods investigated, was considered the most valuable.

Abattoirs↗

PubMedDate not supplied

Intraparenchymal cerebral cysticercosis in children: a benign prognosis.

This paper reports 26 consecutive cases of cerebral cysticercosis in children, 21 presenting with intraparenchymal mass lesions, two with encephalitic disease, and three with intraventricular (racemous) cysticercosis. The intraparenchymal and encephalitic forms of the disease were benign. Regression of the lesions occurred within four months of diagnosis in all children treated conservatively with antiepileptic drugs, but no antiparasitic drugs. Major morbidity was limited to those patients who were subjected to operative intervention. Intraventricular disease was most malignant; all three patients manifested acute, severely increased intracranial pressure, all required immediate surgical decompression, and one patient died. The apparent overall benign course of intraparenchymal cerebral cysticercosis in children appears not to warrant antiparasitic drug therapy.

Adolescent↗

PubMed2004

A Bayesian approach for estimating values for prevalence and diagnostic test characteristics of porcine cysticercosis.

Several diagnostic techniques are used to estimate the prevalence of the zoonotic tapeworm Taenia solium in pigs, but none of these tests are perfect, making interpretation of results difficult. A Bayesian approach was used to estimate values for the prevalence and diagnostic test characteristic of porcine cysticercosis by combining results of four imperfect tests. Village pigs (N = 868) slaughtered in Lusaka (Zambia), were bled, and tongue and routine meat inspected; and serum antibody and parasite antigen concentrations were determined by ELISA. A model, based on a multinomial distribution and including all possible interactions between the individual tests required 31 parameters to be estimated, but actually allowed only 15 parameters (i.e. had 15 degrees of freedom) to be estimated. Therefore, prior expert opinion on specificity and (in)-dependence of the tests was entered in the model, resulting in a reduction of the number of parameters to be estimated. The estimated prevalence of porcine cysticercosis was 0.642 (95% confidence interval 0.54-0.91). The performances of the tests were (sensitivity (se)-specificity (sp)): tongue inspection (se 0.210-sp 1.000), meat inspection (se 0.221-sp 1.000), Ab-ELISA (se 0.358-sp 0.917), Ag-ELISA (se 0.867-sp 0.947). To validate the estimates obtained from the model we performed a second study: 65 randomly purchased Zambian village pigs were bled for serum antibody and antigen determination, their tongue and meat inspected; and in addition, the carcasses were dissected for total cysticercus counts (gold standard). Cysticerci were found in 31 pigs (prevalence 0.477, 95% confidence interval 0.35-0.60), overlapping with the estimated prevalence in the first study. Sensitivity and specificity values obtained for the aforementioned tests in this study were in agreement with those estimated. A Bayesian analysis framework offers the possibility to combine prior opinion with experimental data to more accurately estimate the real prevalence of porcine cysticercosis in the absence of a gold standard.

Animals↗

PubMed2005

Current status of Taenia solium and cysticercosis in Papua New Guinea.

There is no evidence that taeniasis due to Taenia solium is present in Papua New Guinea (PNG), but there is some serological evidence that human cysticercosis exists at particular locations near the border with West Papua (Indonesia), where refugees from across the border have been settled. Only a few surveys have been conducted; the first was in 1986, when one refugee who originated from an infected locality in West Papua was found to be serologically positive, but asymptomatic. Subsequently, there have been unpublished reports of more positive but asymptomatic cases amongst refugees and, it is claimed, amongst local inhabitants that live near the border. A serological survey conducted in PNG in 1999 at the southern end of the border revealed no positive cases of cysticercosis. There are no reports of pigs or dogs affected with cysticercosis in PNG.

Animals↗

PubMed2006

A case of intramuscular cysticercosis diagnosed definitively by mitochondrial DNA analysis of extremely calcified cysts.

A case of obsolete intramuscular cysticercosis diagnosed definitively by mitochondrial DNA analysis of extremely calcified cysts was reported. X-ray and computed tomography findings highly suggested cysticercosis due to Taenia solium; however, no direct evidence of cysticercosis was obtained through serological or histopathological examinations. Mitochondrial DNA analysis of a histopathological specimen confirmed the causative agent to be the Asian genotype of T. solium.

Aged, 80 and over↗

PubMed2005

Evaluation of clinical and serological data from Taenia solium cysticercosis patients in eastern Inner Mongolia Autonomous Region, China.

Neurocysticercosis (NCC) is one of the major causes of neurological disease in China. ELISA and immunoblotting using glycoproteins purified by preparative isoelectric focusing were used to detect human cysticercosis in Tongliao area, Inner Mongolia, China in 1998. Approximately 89% (39 of 44 inpatients and outpatients with suspected NCC at Tongliao City Hospital) were residents of Inner Mongolia. About 53% were male and 77% were of working age (18-59 years), and 32% were farmers. Immunoblotting and ELISA showed a high correlation. Of the 44 patients, 31 positive by cerebral computed tomography (CT) scan were confirmed serologically to have cysticercosis. In the ELISA, patients with no lesions by CT scan had lower OD values, similar to those of normal serum. These findings confirm that both ELISA and immunoblotting assays are sufficiently sensitive to detect asymptomatic or symptomatic cysticercosis patients.

Adolescent↗

PubMed2004

Risk factors for the prevalence of porcine cysticercosis in Mbulu District, Tanzania.

To estimate prevalence of and risk factors for the prevalence of porcine cysticercosis in Mbulu District, Tanzania, 770 live pigs were examined by lingual examination in 21 villages. Structured observations and questionnaire interviews were used to assess pig rearing practices and household use of latrines. Associations between factors were analyzed using a Bayesian hierarchical model to obtain prevalence odds ratio (OR) and 95% Bayesian Credible Intervals (95% BCI). Prevalence was 17.4% (village-specific range 3.2-46.7%). Prevalence of porcine cysticercosis was considerably higher in pigs reared in households lacking latrines than in those reared in households that were using latrines (OR = 2.04; 95% BCI = 1.25, 3.45). About 96% of the pigs were kept under free-range conditions. This study suggests the need for further studies in order to design and implement effective prevention and control measures for porcine cysticercosis in Mbulu District, Tanzania.

Animal Husbandry↗

PubMed2006

Epidemiological survey of swine cysticercosis using ante-mortem and post-mortem examination tests in the southern highlands of Tanzania.

Pig keeping is known to be popular in the regions of the southern highlands zone (Mbeya, Iringa and Ruvuma) of Tanzania where more than 60% of pigs under the small-scale production system are raised. However, no epidemiological surveys on porcine cysticercosis have been conducted in the zone in spite of unofficial reports indicating the disease to be a widespread problem. To estimate prevalence rates and risk factors for porcine cysticercosis in Chunya and Iringa Rural Districts and Ruvuma Region (Songea and Mbinga Districts), 722, 808 and 302 live pigs, respectively, were examined by lingually and the prevalence of swine cysticercosis was found to be 7.6%, 8.4% and 16.9% for Chunya and Iringa Rural Districts, and Ruvuma Region, respectively. Structured observations and questionnaire interviews were used to analyse pig rearing practices and household use of latrines in Chunya and Iringa Rural Districts only. The analysis of effect of pig management practices, lack of a latrine, eating undercooked pork, home slaughter and no inspection of pork and lack of knowledge of T. solium on their association to tongue positivity in pigs was done by means of a contingency table. Odds ratios (OR) with corresponding 95% confidence intervals (95% CI) and p-values were calculated. Structured questionnaire interviews identified factors associated with the disease prevalence in both Chunya and Iringa Rural Districts were free-ranging of pigs, home slaughtering of pigs and pork not being inspected. While in Chunya and Iringa Rural Districts lack of latrine and barbecuing were found a risk factor, respectively. To control the disease in the study areas of the southern highlands there is a need for significant improvements regarding the use of latrines, confinement of pigs, pork inspection and thorough cooking of pork.

Animal Husbandry↗

PubMed2006

Risk factors associated with porcine cysticercosis in selected districts of Eastern and Southern provinces of Zambia.

To determine the risk factors associated with Taenia solium transmission in humans and pigs in the rural areas of Eastern and Southern provinces of Zambia, a questionnaire was administered in 788 households from 155 villages. Pigs were examined from 800 households. Tongue examination and enzyme-linked immunosorbent assay (Ag-ELISA) for the detection of circulating antigens of T. solium cysticerci were used to measure infection in pigs. A snowballing technique was utilised to select households with pigs. Prevalence of households with pigs infected with T. solium on tongue examination by district ranged from 12.7% to 32.1% with Ag-ELISA having a range of 30.0-51.7%. Of the total number of households visited, 18.8% and 37.6% had at least one pig positive for porcine cysticercosis on tongue examination and Ag-ELISA, respectively. Risk factors associated with T. solium infection were lack of pork inspection at slaughter (96.7%), consumption of pork with cysts (20.1%), selling of pork infected with T. solium cysticerci (18.3%), free-range husbandry system (83.2%) and absence of latrines (58.0). Free-range husbandry system (OR=1.68; 95% CI=1.36-2.07) was a significant risk factor for porcine cysticercosis in the surveyed areas. The result that pigs were mostly kept on free-range and semi-intensive husbandry systems may have permitted them to have access to eating human faeces that could be contaminated with tapeworm eggs. This study has shown that T. solium infection poses a high public health risk in the study areas and urban areas as well. We recommend that a human survey be conducted to verify the human exposure to taeniasis and/or cysticercosis in Zambia.

Abattoirs↗

PubMed2001

Extraocular muscle cysticercosis presenting as Brown syndrome.

PURPOSE: Report of a case of acquired Brown syndrome caused by infestation of the superior oblique muscle by Cysticercus cellulosae. METHOD: Case seen in a referral practice. A 20-year-old man presented with recurrent attacks of conjunctivitis and diplopia in upgaze. Clinical examination of ocular motility established a diagnosis of acquired Brown syndrome of the right eye. Computed tomography of the right orbit unequivocally established the diagnosis of superior oblique muscle cysticercosis. The patient was started on systemic steroids and albendazole in the prescribed doses for a month. RESULT: Serial computed tomography scans of the orbit revealed resolution of the cystic lesion after a month. Clinically, although there was restoration of ocular motility in upgaze, mild restriction of movement of the right eye in levoelevation persisted. However, the patient was symptomatically better with amelioration of the recurrent conjunctivitis and diplopia in primary gaze. CONCLUSION: Extraocular muscle cysticercosis should be considered in the differential diagnosis of acquired motility disorder. The presentation of extraocular muscle cysticercosis as an acquired Brown syndrome is unusual. Response to medical therapy was satisfactory.

Adult↗