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PubMed1998

Cysticercosis of the oral cavity: report of five cases and a review of literature.

This paper reports on five cases of cysticercosis of tongue and buccal mucosa, diagnosed on fine-needle aspiration cytology (FNAC), affecting child patients who presented between January 1994 and October 1997. Four cases presented with gradually increasing nodular swelling of the dorsum of tongue and in the fifth case the swelling was situated on the buccal mucosa of the left side. A clinical diagnosis of cysticercosis was not entertained in any of these patients, who each presented with a solitary lesion; instead, it was considered to be a benign cyst or benign tumour of salivary gland or mesenchymal tissue, before FNAC diagnosis. These lesions of the oral cavity may present first to a dentist and, in endemic areas, cysticercosis should be included in the differential diagnosis of solitary nodular lesions of the oral cavity, particularly in young individuals.

Cheek↗

PubMed2002

Optic nerve cysticercosis.

Cysticercosis of the optic nerve is an extremely rare entity and only seven cases have been reported in the world literature. A case of optic nerve cysticercosis in a 25-year-old woman is reported, along with a review of literature. The patient presented with two episodes of pain, diminution of vision and proptosis. Computed tomography and ultrasonography revealed an intraneural cyst with scolex in the retrobulbar portion of the optic nerve. A positive enzyme-linked immunosorbent assay test for cysticercosis further confirmed the diagnosis. Medical therapy in the form of oral albendazole and steroids resulted in complete resolution of the cyst, with few visual sequelae.

Adult↗

PubMedDate not supplied

The use of urban sewage sludge on pastures: the cysticercosis threat.

Urban sewage production is increasing and its agronomical use as a fertiliser has been advocated. Considerable defiance is prevalent in consumers and among farmers on the use of such fertilisers due to unknown pathological or environmental risks. The aim of the present review was to consider which pathological risk is major. Cysticercosis due to Taenia saginata appears to be one of the major pathological threats when sewage sludge is used to fertilise cattle pastures in temperate areas. The situation is different in Africa (Taenia solium and T. saginata are both highly prevalent) and Asia (Taeniasaginata-like are prevalent). The processing of sludge and the delay between its application onto a pasture and grazing are probably major risk factors. Little data are available on the influence of processing, delay between processing and the use of sludge on the pathogenic risk. Producers and consumers will be more confident on the use of sludge if objective data are gained on risk. Most of the cases of cysticercosis (North America, United-Kingdom, Germany or Denmark) are related to poor human hygiene or accidental overflooding of sewage plants onto pastures. The standard application of sludge on pastures is apparently at low risk. This low risk does not mean that surveillance should cease since outbreaks of cysticercosis have been reported. Future investigations should concentrate on the most sustainable means of reducing risk (length of storage before use, composting, other treatments).

Animals↗

PubMed2003

[Cysticercosis as a rare cause of a tumor of the tongue].

This article presents the case of a 19-year-old male patient with cysticercosis in the tongue and the CNS. It also presents images of histological sections of the cysticercus parasite situated in the tongue muscles and CT and MRI images of cerebral clusters. Cysticercosis is a disease caused by the hydatid of the porcine tapeworm (cysticercus). Cysticercus normally dwells in the organs of pigs. Infection of human tissues is much more unusual and affliction of the oral cavity can be regarded as a rarity. In this case the patient complained about a painless, clearly delineated induration in the anterior third of the left half of the tongue. Histological investigation resulted in the diagnosis of cysticercosis. The patient was referred to an Institute for Tropical Medicine which confirmed the diagnosis serologically. CT and MR images revealed two additional lesions in the CNS. After treatment with anthelminthics these lesions in the CNS disappeared.

Adult↗

PubMed2003

Acquired brown syndrome secondary to superior oblique muscle cysticercosis.

BACKGROUND: Acquired Brown syndrome is known to occur after trauma, iatrogenic events, cysts of superior oblique muscle tendon, and inflammation. The purpose of this study is to report a large series of patients with acquired Brown syndrome secondary to superior oblique muscle cysticercosis and to discuss its management. METHODS: Retrospective analysis was performed of clinical and imaging features, management, and outcome in seven patients with cysticercosis of the superior oblique muscle presenting clinically as Brown syndrome. RESULTS: Seven patients were identified (five male and two female) ranging in age from 6 to 45 years. All patients had the ocular motility limitation, ie, limitation of elevation in adduction., characteristic of Brown syndrome. This was associated with pain and swelling in the superior nasal orbit. Diagnosis was established by observing the cysticercus cyst with scolex on imaging (ultrasound B scan, magnetic resonance imaging, and/or computed tomography). Oral albendazole (15 mg/kg) and oral prednisolone (1mg/kg) were given for 4 weeks, and the patients were followed up for 1 year. Clinical recovery with improvement of ocular motility and regression of imaging features was noted in all patients. CONCLUSIONS: Acquired Brown syndrome secondary to superior oblique muscle cysticercosis is a rare entity. Awareness of this condition, which leads to early diagnosis and institution of prompt medical treatment, results in a successful clinical outcome.

Adolescent↗

PubMed1998

Taenia crassiceps invasive cysticercosis: a new human pathogen in acquired immunodeficiency syndrome?

A fluctuant, painful, subcutaneous, and intermuscular tumor developed in a 38-year-old man with severe acquired immunodeficiency syndrome (AIDS) in which immunodeficiency was severe. Surgery revealed lesions that formed a multilocular pouch embedded in deep tissues in the forearm filled with tapiocalike material containing a viscous fluid, granules, and cysticercilike small vesicles. Pathologic and parasitologic evaluation showed cysticerci embedded in a fibrocollagen reaction with inflammatory granulomatous reaction. Each cysticercus contained an invaginated scolex with two rows of small (i.e., 80 microm) and large (i.e., 114 microm) rostellar hooks, identical to larva of Taenia crassiceps. All clinical, parasitologic, and pathologic features of these cysticerci were very different from those of all other larval cestode (i.e., Taenia solium cysticercosis, coenurosis, sparganosis, cysticercosis due to Taenia saginata [Cysticercus bovis], primary and secondary hydatidosis [Echinococcus species]). T crassiceps cysticerci usually develop in subcutis and pleuroperitoneal cavities of rodents, whereas the adult tapeworm is commonly found in the digestive tract of foxes. Biologic properties of T crassiceps cysticerci and epidemiologic characteristics of pandemic human immunodeficiency virus (HIV) could eventually indicate new potential cases of T crassiceps cysticercosis in humans.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

MRI of intraventricular cysticercosis: surgical implications.

OBJECTIVE: Our goal was to evaluate the role of Gd-enhanced MR in the diagnosis and surgical planning of intraventricular cysticercosis cysts. MATERIALS AND METHODS: Thirty-three patients with intraventricular cysticercosis were evaluated with Gd-enhanced MRI including follow-up studies ranging over time periods from 6 months to 8 years. The patient age ranged from 17 to 65 years. All had lived in Mexico or Central America. RESULTS: Twenty patients had surgical removal of the cysts. The majority of patients (18 of 20) who had surgical removal of the cyst showed improvement with resolution of hydrocephalus. Two of 20 patients required additional shunting to alleviate hydrocephalus. In these two patients, Gd-enhanced MR showed cyst wall enhancement. Ependymitis with adhesion was found at surgery in these two patients. Nine patients had shunt placement; one of nine patients showed cyst enlargement 2.5 years later that required surgical removal. Of the remaining eight patients, four showed irregular, thick, ring-like enhancement mimicking a neoplasm on follow-up imaging studies. Four patients with cysts in the lateral ventricle did not require treatment. Two of the four patients showed irregular, thick, ring-like enhancement on follow-up imaging studies. CONCLUSION: Gadolinium-enhanced MR is more sensitive than contrast-enhanced CT for detecting ependymitis, which is essential in deciding whether surgical removal of the cyst or shunt placement is indicated. A degenerating intraventricular cysticercosis cyst may present as an irregular, thick, ring-like enhancing lesion or a nodular enhancing lesion with varying degrees of surrounding edema, mimicking a neoplasm.

Adolescent↗

PubMed2000

Cysticercosis of the optic nerve.

Cysticercosis of the optic nerve has been reported only twice in the literature. A case of optic nerve cysticercosis in a 50-year-old woman with atypical optic neuritis is reported. Computerized tomography showed a thickened left optic nerve with a ring-enhancing lesion containing an eccentric nodule. An enzyme-linked immunosorbent assay test for cysticercosis further established the diagnosis. The patient was treated with oral prednisolone and albendazole, with no improvement in vision.

Albendazole↗

PubMedDate not supplied

Solitary cysticercosis in the intermuscular area of the thigh: a rare and unusual pseudotumor with characteristic imaging findings.

A 33-year-old woman with cysticercosis presenting as a solitary tumor between the adductor muscle groups of the thigh is reported. Although such solitary soft tissue cysticercosis is rare and there are no sporadic reports in the literature with an intermuscular presentation, the typical appearance of the larvae within the mass made the diagnosis in this case easier compared with other cases of solitary soft tissue cysticercosis reported in the literature.

Adult↗

PubMed1986

Cysticercosis: etiology and nursing care.

Cysticercosis is the most common parasite affecting the central nervous system and is a serious health problem in many parts of the world. An increase in immigrants to the United States from areas with a high incidence of cysticercosis has made it a relatively common diagnosis at neurological centers. This article describes the etiology of cysticercosis and assessment, treatment, and follow-up care of these patients.

Central Nervous System Diseases↗

PubMed2006

Estimation of the cost of Taenia solium cysticercosis in Eastern Cape Province, South Africa.

OBJECTIVES: To provide a comprehensive estimate of the societal costs of Taenia solium cysticercosis for the Eastern Cape Province (ECP), South Africa, as an objective measure of its impact in this endemic area. METHODS: Epidemiological data on the prevalence of epilepsy, proportion of epilepsy cases due to neurocysticercosis (NCC) and consequences of cysticercosis were gathered from published and unpublished sources. Economical data were mostly obtained from governmental sources. Three methods were used for estimating productivity losses. Monte Carlo sampling was used to represent the uncertainty of the estimates with 95% Credible Intervals (95% CI). The estimation is for 1 year using a societal approach. All costs are reported in 2004 US Dollars. RESULTS: Overall, there were an estimated 34 662 (95% CI: 17 167-54 068) NCC-associated cases of epilepsy in ECP in 2004. The overall monetary burden (in million of US Dollars) was estimated to vary from US Dollars 18.6 (95% CI: US Dollars 9.0-32.9) to US Dollars 34.2 (95% CI: US Dollars 12.8-70.0) depending on the method used to estimate productivity losses. The agricultural sector contributed an average of Dollars 5.0 million. The prevalence of epilepsy, proportion of productivity reduction and the proportion of epilepsy cases attributable to NCC had the largest impact on the overall estimates. CONCLUSION: This preliminary estimate suggests that T. solium cysticercosis results in considerable monetary costs to a region that is already economically constrained. Because this infection is preventable, these results could guide stakeholders in deciding where to invest scarce health and agricultural resources in their countries.

Agriculture↗

PubMed1995

Cerebral and subcutaneous cysticercosis treated with albendazole.

BACKGROUND: Cysticercosis is the most common parasitic disease of the central nervous system in the world, but cysticercosis cutis has been reported much less frequently. Because 54% of patients present with subcutaneous nodules, we report here the association of cysticercosis cutis in a patient with neurocysticercosis and review the literature and treatment options. CASE REPORT: The patient presented with multiple, asymptomatic subcutaneous nodules over the trunk and the extremities, associated with central nervous system involvement. Examination of an excised nodule by light microscopy revealed a larval cyst in the deep dermis surrounded partly by a fibrous pseudocapsule. Computed tomographic scanning af the skull showed multiple, nonenhancing, and calcified cycts in both cerebral hemispheres. Treatment with albendazole, 15 mg/kg/day for 30 days, was highly effective. At follow-up 6 months later, most subcutaneous nodules had disappeared or were markedly reduced in size, and the cerebral lesions had much improved. CONCLUSIONS: Albendazole, a newer paracidal drug, seems to be more effective and less expensive than some other drugs in use for the treatment of neurocysticercosis.

Adult↗

PubMed1998

Optic neuritis following albendazole therapy for orbital cysticercosis.

PURPOSE: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis. METHODS: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss 1 week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve. RESULTS: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery. CONCLUSION: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.

Administration, Oral↗

PubMed2006

Lack of specificity of a single positive 50-kDa band in the electroimmunotransfer blot (EITB) assay for cysticercosis.

Diagnosis of the parasitic infection cysticercosis is usually confirmed by serological assays. The electroimmunotransfer blot (EITB) for cysticercosis is a sensitive and specific assay, which uses six glycoprotein antigens on a strip to detect antibodies to Taenia solium cysticerci. Although the appearance of bands at any of these six sites is considered to be a positive result, a growing body of evidence suggests that the presence of a single 50-kDa band in this assay may not indicate infection. An audit of 984 samples tested over a 3-year period showed that only two (15.4%) of 13 samples with a single 50-kDa band were associated with a diagnosis of cysticercosis. Possible reasons for this include technical problems, cross-reactivity with other parasites or other diseases, or the presence of a non-specific band. The results suggest that the finding of a single 50-kDa band should be interpreted with caution.

Animals↗

PubMed2000

Cysticercosis of the oral cavity: report of seven cases.

Cysticercosis is a condition in which a human acts as the intermediate host of the pork tapeworm Taenia solium. Although cysticercosis is a common disease in some regions of the world and can occur in any body site, oral lesions are rare. This paper reviews the natural history of the disease and reports on seven cases of oral cysticercosis.

Adolescent↗

PubMed1992

Production of anti-idiotypic antibodies as potential immunoreagents for the serological diagnosis of bovine cysticercosis.

Although serological assays have been developed for cysticercosis, difficulties remain in isolating antigens from cross-reacting components and in obtaining reliable sources of parasite material for purification. The object of this study was to demonstrate the feasibility of using anti-idiotypic antibodies as alternative immunoreagents for the serological diagnosis of bovine cysticercosis. A fraction of Taenia hydatigena cyst fluid (ThFAS) had previously been used as a diagnostic antigen for Taenia saginata cysticercosis. Rabbits and mice were inoculated with ThFAS to produce either polyclonal or monoclonal antibodies (idiotypes), respectively. Idiotypes were purified by preparative protein A column, then inoculated into other rabbits to produce anti-idiotypes. The presence of anti-idiotypes in hyperimmune serum was demonstrated by competitive inhibition ELISA. Then anti-idiotypes were purified and used as coating antigen in a plate ELISA; results were compared to those using ThFAS as coating antigen. Anti-idiotypes yielded results comparable to those obtained with the native antigen and thus can be used as synthetic antigens for diagnostic purposes.

Animals↗

PubMed1986

Anticysticercous antibodies in serum and cerebrospinal fluid in patients with cerebral cysticercosis.

Fifty-one cases of cerebral cysticercosis proved by surgery or CT scanning were studied prospectively with the ELISA test in order to detect anticysticercous antibodies in blood and CSF. The ELISA test was also performed for detection of antibodies in 20 control patients who had CSF withdrawn during a myelogram and in 119 serum samples of asymptomatic subjects. We found an overall sensitivity of the ELISA test in the blood of 87% with a specificity of 90%. In the CSF we found a sensitivity of 87% with a specificity of 100%. However, when we compared patients with cerebral cysticercosis of a benign type with patients with cerebral cysticercosis of a malignant type we found a serum sensitivity of 75% for the benign group as compared to 93% of the malignant group. The CSF sensitivity was 80% in the benign group and 93% in the malignant group. This difference was statistically significant.

Adolescent↗

PubMed1997

Treatment of porcine cysticercosis with oxfendazole: a dose-response trial.

Taenia solium cysticercosis is an important public health problem in developing countries. Oxfendazole has been shown to be highly effective against porcine cysticercosis, when given as a single dose at 30 mg/kg bodyweight. This dose, however, was estimated from experience with albendazole. A controlled dose-response trial was therefore undertaken to determine the efficacy and safety of three concentrations of oxfendazole. Twenty-four naturally parasitised pigs were divided into four groups and treated with oxfendazole at 10 mg/kg, 20 mg/kg or 30 mg/kg, or left untreated. Eight to 10 weeks later the pigs were killed and the viability of the parasites assessed by evagination. No side-effects of oxfendazole treatment were observed. In the control group more than 90 per cent of the cysts were viable. Viable cysts were found in the muscle and brain of the pigs treated with 10 or 20 mg/kg oxfendazole. At 30 mg/kg there were no viable cysts in any of the tissues examined, indicating that this concentration of oxfendazole provided an effective treatment against porcine cysticercosis.

Animals↗