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PubMed1996

Genetic control of susceptibility to Taenia crassiceps cysticercosis.

We previously reported that genes within the major histocompatibility complex influence the intensity of Taenia crassiceps murine cysticercosis. This genetic control, readily apparent in mice of BALB background, was further studied in H-2 congenic and recombinant B10 mice as well as in BALB/c substrains differing in expression of Qa-2 antigens. Similarly low parasite numbers were found in all B10-derived strains infected, regardless of H-2 haplotype, indicating that the effect of H-2 genes in controlling susceptibility is overridden in mice of B10 background. BALB/c substrains differed significantly in susceptibility. BALB/cAnN was highly susceptible, whereas BALB/cJ, in contrast, was highly resistant and BALB/cByJ showed intermediate susceptibility. Susceptibility or resistance in BALB/c substrains may be associated to differences known to distinguish them, such as serum testosterone levels and Qa-2 protein expression. In bidirectional F1 hybrids of C57BL/6J and BALB/cAnN resistance to cysticercosis was inherited as a dominant autosomal trait. In F1 hybrids of BALB/cJ with BALB/cAnN, BALB/cByJ and BALB.K resistance was also inherited as a dominant trait. However, in (BALB/cAnN x BALB/cByJ)F1 and (BALB/cAnN x BALB.K)F1 hybrids, dominant susceptibility to cysticercosis was observed.

Animals↗

PubMed2002

Sequential expression of the neuropeptides substance P and somatostatin in granulomas associated with murine cysticercosis.

Neurocysticercosis, a parasitic infection of the human central nervous system caused by Taenia solium, is a leading cause of seizures. Seizures associated with neurocysticercosis are caused mainly by the host inflammatory responses to dying parasites in the brain parenchyma. We previously demonstrated sequential expression of Th1 cytokines in early-stage granulomas, followed by expression of Th2 cytokines in later-stage granulomas in murine cysticercosis. However, the mechanism leading to this shift in cytokine response in the granulomas is unknown. Neuropeptides modulate cytokine responses and granuloma formation in murine schistosomiasis. Substance P (SP) induces Th1 cytokine expression and granuloma formation, whereas somatostatin inhibits the granulomatous response. We hypothesized that neuropeptides might play a role in regulation of the granulomatous response in cysticercosis. To test this hypothesis, we compared expression of SP and expression of somatostatin in murine cysticercal granulomas by using in situ hybridization and immunohistochemistry. We also compared expression with granuloma stage. Expression of SP mRNA was more frequent in the early-stage granulomas than in the late-stage granulomas (34 of 35 early-stage granulomas versus 1 of 13 late-stage granulomas). By contrast, somatostatin was expressed primarily in later-stage granulomas (13 of 14 late-stage granulomas versus 2 of 35 early-stage granulomas). The median light microscope grade of SP mRNA expression in the early-stage granulomas was significantly higher than that in the late-stage granulomas (P = 0.008, as determined by the Wilcoxon signed rank test). By contrast, somatostatin mRNA expression was higher at later stages (P = 0.008, as determined by the Wilcoxon signed rank test). SP and somatostatin are therefore temporally expressed in granulomas associated with murine cysticercosis, which may be related to differential expression of Th1 and Th2 cytokines.

Animals↗

PubMed2002

Deaths associated with cysticercosis. Report of three cases and review of the literature.

There is significant concern about an increased risk of death in patients with neurocysticercosis who receive antihelminthic agents. To clarify the risk factors for death associated with cysticercosis, the authors identified all cases of mortality over a 5-year period in patients in whom cysticercosis was diagnosed and who were discharged from a major metropolitan medical center. In addition, they reviewed the literature to delineate risk factors associated with cysticercosis-related death, concluding that the risk of death is highest in patients with heavy cyst burdens and those surgically treated for intracranial hypertension. Death is rare in properly selected patients with parenchymal disease in whom the cyst burden is low and intracranial hypertension is absent. The most common causes of death appear to be 1) intracranial hypertension in surgically treated patients and 2) shunt infection.

Adult↗

PubMed1978

A Histopathological Study On Human Cysticercosis.

A study was made on 258 cases of cysticercosis, that were examined and diagnosed at the Department of Pathology, College of Medicine, Seoul National University during a period of 9 years from 1968 to 1976 inclusive. There were a total of 35,363 surgical specimens examined during the same period, thus revealing the relative frequency ratio of cysticercosis among surgical accessions to be 0.73%. The common sites of involvement of cysticercosis were skeletal muscle, subcutaneous tissue, breast, brain and eye in decreasing order of frequency. Painless palpable nodules were the most common initial presentation clinically. Histopathological staging was attempted based on the host tissue reaction and worm morphology. It was arbitrarily classified into early, intermediate and late stages. In general the morphology of the parasite consisted of a well preserved and compact calcospherules with intact subcuticular muscle layer in the early stage, showing a progressive deterioration of parasitic structures, finally undergoing resorptive process or mummification. The host tissue reation in the early stage was characterized by a diffuse epithelioid cell proliferation with lymphocytic and eosinophilic infiltration without capsule formation. The intermediate stage consisted of a diffuse histiocytic proliferation with well formed outer collagen capsule. The latestage revealed mostly thinned out, well collagenized capsule with scanty lymphocytic infiltration. The parasite in the well formed cyst as usually distorted and often mummified. But the hooklets were relatively preserved up to the late stage. These finding suggest that the host tissue reacts to the cysticercus worm in fairly uniform fashion, and this fashion appears to have a sequence, i.e., violent lymphohistiocytic response in the initial phase of infection, and undergoing a gradual fibrotic (encapsulating) self-limiting course, finally being stabilized by a dense, acelluar collagen capsule or collapse and absorption.

Journal Article↗

PubMed2005

A seroepidemiological survey of Taenia solium cysticercosis in Nabo, Guangxi Zhuang Autonomous Region, China.

We have observed the seropositive rate of Taenia solium cysticercosis in residents at Nabo Village, Tiandong County, Guangxi Zhuang Autonomous Region, China by enzyme linked immunosorbent assay. The village had been found to be a relatively high endemic area of porcine cysticercosis among roaming pigs. Of 202 persons examined four males aged 15, 25, 35 and 41 year-old exhibited absorbance (abs) at 0.18, 0.20, 0.35 and 0.55, respectively. In addition, two females whose ages were 35 and 39 years revealed specific antibody levels of abs 0.26 and 0.41 in their sera. Overall positive rate among the people was 2.97%. All of these persons agreed that they had ingested the pork infected with T. solium metacestode (TsM), while history of proglottid discharge was not noticed from all of them. Three males and one female complained of intermittent headache. Our findings reinforced not only that the prevalence of cysticercosis might be related with roaming pigs infected with TsM but also that behavioral and environmental practices in local community constituted risk factors for transmission of the infection.

Adolescent↗

PubMed1999

[Changes in computed tomogram in cerebral parenchymal cysticercosis treated with albendazole].

AIM: To observe the changes in cerebral computed tomogram (CT) in cerebral parenchymal cysticercosis after albendazole treatment. METHODS: Cerebral CT scanning was conducted in 57 patients with cerebral cysticercosis in our hospital before, during and after albendazole treatment. RESULTS: Cerebral CT might be normal before onchospheres became cysticercariae in the brain. Small cystic lesions could turn into other CT signs of cerebral cysticercosis after albendazole treatment. CONCLUSION: Normal cerebral CT cannot rule out the disease. Small cystic lesions are the earliest pathological and active signs of the disease. Nodular focus occurs after the death of Cysticercus and calcification is the final outcome of the disease.

Adolescent↗

PubMed2002

[Evaluation of Gd-DTPA enhanced MR in the diagnosis of the degeneration stage of cerebral cysticercosis].

OBJECTIVE: To detect the value of qualitative and orientating diagnosis in the degeneration stage of cerebral cysticercosis with Gd-DTPA enhanced MR. METHODS: Sixty-nine cases of cerebral cysticercosis were diagnosed by enhanced MR as degeneration stage, and confirmed by immunological examination and/or by surgery. MR plain scanning was conducted for the same cases. RESULTS: The plain scanning showed single or multiple lesions with long T1 and long T2 signals, and the enhanced scanning showed nodular or annular lesions. The diameter of the lesion after enhanced scan was not more than 22 mm with an average value of 8.1 mm. Some cases showed single lesion on plain scanning but showed multiple lesions after enhanced scan. CONCLUSION: The enhanced MR shows more typical features of the degeneration stage cerebral cysticercosis. It can define the number, position and range of the lesions, and can improve the accuracy of differential diagnosis, and therefore be of importance in formulating treatment scheme and prognosis.

Adolescent↗

PubMed2003

[Study on diagnosis of cerebral cysticercosis by antibody detection and imaging techniques].

OBJECTIVE: To establish new criteria of antibody detection for the diagnosis of cerebral cysticercosis in combining with imaging examinations for reducing the missed and neglected diagnosis of the disease. METHODS: 1,160 cases with adequate clinical data were collected for the study, among them all cases received antibody detection and computerized tomography(CT), 538 cases were examined by magnetic resonance imaging(MRI). Following the locations that cysticerci parasitized, the cases were grouped in four types of cerebral cysticercosis: 1,087 cases in brain parenchyma (93.7%), 42 cases in brain ventricles (3.6%), 22 cases in brain meninges (1.9%), and 9 mixed cases (0.8%). According to the number of cysticerci showed by imaging analysis, cases involving parenchyma were further divided as subgroups of slight, moderate, and heavy infection with 1-2, 3-9 and over 10 parasites, with 552 cases(50.8%), 443 cases (39.8%) and 102 cases (9.4%) respectively. IHA and ELISA were used for detecting antibodies in the sera. RESULTS: 635 cases showed an IHA titer of 1:8 and above (54.7%), 700 cases (60.3%) showed positive ELISA and 460 cases (39.7%) showed weak positive. In the group of light infection (552 cases), 94.7% showed an IHA titer of less than 1:8, only 29 cases (5.3%) with a titer of 1:8 and above; 94 cases (17%) showed positive ELISA and 458 cases (83%) were weak positive. In the groups of moderate and heavy infections, all cases showed IHA titer of 1:8 and over, and positive or weak positive ELISA. CONCLUSION: Antibody titers are positively relevant to the intensity of Cysticercus infection. Most cases with light infection showed a low IHA titer (less than 1:8) and a weak positive ELISA, a fact that these cases would have been missed by the immunological tests. Therefore, an integrated analysis of the results with immunological test and clinical imaging technique is important in diagnosing cerebral cysticercosis.

Adolescent↗

PubMed2002

Surgical treatment of cerebral cysticercosis: long-term results and prognostic factors.

OBJECT: Cysticercosis is the most frequent parasitosis of the central nervous system. Although anticysticercal drugs have proven efficient in some cases, many patients with NCC require palliative, occasionally curative, surgical procedures. The authors analyzed the data and prognostic factors obtained during the follow-up period (range 1-255 months, median 38 months) in 160 patients with cerebral cysticercosis who underwent surgical treatment. METHODS: Different surgical approaches were indicated to control increased intracranial pressure (ICP) in most patients, and some patients had undergone decompressive surgery for local brain lesions. Most patients required more than one surgical procedure. Statistical analysis was performed using the Fisher exact, the log-rank, and the Kruskall-Wallis tests. Survival curves were calculated according the Kaplan-Meier method. The removal of a giant cyst from the parenchyma or cisterns for relief of increased ICP and for chiasm/optic nerve decompression improved most symptoms in patients. The removal of ventricular cysts was effective in the control of increased ICP in most patients. Patients with a ventricular cyst and ependymitis/arachnoiditis required placement of a ventriculoperitoneal (VP) shunt after the cyst was removed. This therapy effectively controlled increased ICP. Patients younger than 40 years of age at the time of treatment and male patients had worse outcomes. The outcome in patients who underwent VP shunt surgery or shunt surgery combined with reservoir implantation was worse than that in those who underwent cyst removal alone. Shunt-related infection was the most frequent complication, and the global mortality rate during the follow-up period was 21.2%. Although both complications were more frequent in the first 2 postoperative years, they occurred at any time. CONCLUSIONS: Long-term prognosis in patients with cerebral cysticercosis who required surgery was not good. Cysts located in the basal cisterns and patient age younger than 40 years were poor prognostic factors.

Adolescent↗

PubMed2005

Short report: secondary transmission in porcine cysticercosis: description and their potential implications for control sustainability.

Taenia solium taeniasis/cysticercosis is one of few potentially eradicable infectious diseases and is the target of control programs in several countries. The larval stage of this zoonotic cestode invades the human brain and is responsible for most cases of adult-onset epilepsy in the world. The pig is the natural intermediate host, harboring the larvae or cysticerci. Our current understanding of the life cycle implicates humans as the only definitive host and tapeworm carrier (developing taeniasis) and thus the sole source of infective eggs that are responsible for cysticercosis in both human and pigs through oral-fecal transmission. Here we show evidence of an alternative pig-to-pig route of transmission, previously not suspected to exist. In a series of four experiments, naive sentinel pigs were exposed to pigs that had been infected orally with tapeworm segments (containing infective eggs) and moved to a clean environment. Consistently in all four experiments, at least one of the sentinel pigs became seropositive or infected with parasite cysts with much lower cyst burdens than did primarily infected animals. Second-hand transmission of Taenia solium eggs could explain the overdispersed pattern of porcine cysticercosis, with few pigs harboring heavy parasite burdens and many more harboring small numbers of parasites. This route of transmission opens new avenues for consideration with respect to control strategies.

Animals↗

PubMed1981

Cutaneous cysticercosis treated with metrifonate.

Cutaneous cysticercosis in humans is an uncommon parasitic infestation. When few nodules are present, surgical excision is effective therapy. For multiple nodules, diverse forms of treatment have been employed. We describe herein a patient with myriad nodules of cysticercosis who showed dramatic improvement after two six-day courses of metrifonate (an organophosphorous compound) administered one month apart. These encouraging results could be of help to other patients, especially those with CNS involvement, although the use of this compound is not without risk.

Administration, Oral↗

PubMed1997

Cysticercosis. Clinical classification based on imaging studies.

Cysticercosis is a pleomorphic disease in which the diagnosis, treatment, and prognosis greatly vary in relation to the location, number, and stage of the lesions. A new classification is proposed that includes the information gathered by magnetic resonance imaging and computed tomography, supplemented by immunodiagnostic studies and clinical data. The different clinical entities produced by cysticercosis are grouped by the frequency and location of the parasites, including valuable data as the number and stage of the lesions as well as the degree of the inflammatory response from the host to the parasite. In this way, the disease can be individualized to define the reliability of diagnostic studies and to design specific therapeutic approaches that depend on the characteristics that the disease acquires in every location.

Brain↗

PubMed1978

Spinal cysticercosis.

Myelopathy in a Cambodian patient proved to be due to cysticercosis. Spinal cysticercosis is rare, and Indochina is an unusual place to have acquired it.

Adult↗

PubMed1981

Cysticercosis of the nervous system. Treatment by means of specific internal radiation.

Five hundred patients with cysticercosis of the nervous system were evaluated by scanning that used anti-Cysticercus antibodies labeled with indium 113. The same antibodies, labeled with iodine 131, were used for radioimmunotreatment. Ninety-six percent of the patients had good or excellent results, whereas only 4% had poor results. None of the patients showed intolerance or radiotoxicity during three months of clinical and laboratory follow-up. The diagnosis, treatment, and prognosis of cysticercosis of the nervous system are dramatically changing, due to the development of anti-Cysticercus antibodies labeled with radionuclides.

Brain Diseases↗

PubMed1982

CNS cysticercosis.

Worldwide, cysticercosis is the most common CNS parasite. Because of immigration from endemic areas, cysticercosis has become more common in the United States. Seventeen cases have been seen at the University of California Medical Center, San Diego (La Jolla) over the last ten years. Eight patients had intracranial hypertension; three, seizures; three, intracranial hypertension; and seizures; two, strokes; and one, retinal involvement. Diagnosis was by surgical biopsy in five cases and by clinical setting plus positive serologic findings in 12. Twelve patients underwent surgical procedures during their illness, one patient died, and five improved with steroid therapy. Clinical, serologic, and pathologic criteria permit definitive diagnosis. Therapy is currently directed toward complications of the primary infection, which usually is inactive at the time of presentation.

Adolescent↗

PubMed1982

Neuro-ophthalmologic signs and symptoms of cysticercosis.

Fifty-six patients with cysticercosis and neuro-ophthalmic signs were examined by me during an 11-year period. Their symptoms generally reflected increased intracranial pressure caused by hydrocephalus, subacute meningitis, cerebral masses or a combination of these effects. Papilledema (37 patients) was the commonest sign, with pupillary abnormalities (16 patients) and nystagmus (12 patients) frequently encountered. Cysticercosis is a relatively benign, although episodic, disease, as long as secondary obstructive hydrocephalus is promptly diagnosed and treated by CSF shunting procedures.

Adolescent↗

PubMed1976

Cysticercosis in otolaryngology.

Cysticercosis is not likely to be the first diagnosis the otologist has in mind when regarding tumors in the head and neck area. The fact that this disease may present a diagnostic and therapeutic problem is illustrated by three cases, appearing in the tongue, buccal mucosa, and midline of the neck, respectively. The local finding of a soft nontender mass, the typical calcifications in the soft tissues visible on roentgenograms, and the histopathological findings are described and illustrated. Attention is drawn to the fact that cerebral cysticercosis, which is a very grave disease, may cause tinnitus, nystagmus, and hearing disturbances.

Adult↗

PubMed1990

Comparison of therapeutic regimen of anticysticercal drugs for parenchymal brain cysticercosis.

The efficacy of different regimens of therapy for parenchymal brain cysticercosis either with praziquantel (PZQ) or with albendazole (ALB) was compared in 114 patients. Four schemes of treatment were used: PZQ 50 mg/kg per day for 15 days, PZQ 50 mg/kg per day for 8 days, ALB 15 mg/kg per day for 30 days, and ALB 15 mg/kg per day for 8 days. Three months after therapy, it was apparent that both PZQ and ALB were effective, as shown by the disappearance of cystic lesions in computed tomographic scans. Thirty-three control patients followed for a mean of 11 months had no spontaneous remission of lesions. When comparing PZQ with ALB, the latter was found to be more effective than the former for both the full and the short course of treatment: 85% vs 60% and 85% vs 48% disappearance of lesions, respectively (P less than 0.001). Comparison of the full vs the short course of PZQ showed that the short course had a further 12% reduction in drug effectiveness. In contrast, the length of ALB therapy could be shortened without lessening its efficacy. Based on these results, an 8-day course of ALB is recommended as treatment for parenchymal brain cysticercosis; a 15-day course of PZQ could be subsequently used in those patients who show only partial response to ALB.

Adolescent↗