Generalized muscular pseudohypertrophy in cysticercosis.
A 32 year old male Hindu, presenting with generalized muscular hypertrophy (Veritable Hercules), together with subcutaneous nodules and epilepsy, due to cysticercosis is described.
Adult↗
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Prevalence of hydatidosis and cysticercosis in slaughtered livestock in Nigeria.
A survey was carried out at Kano abattoir in order to estimate the incidence of hydatidosis and cysticercosis in slaughtered livestock. Of the animal species examined, hydatid disease was found in sheep (11.4 per cent), goats (26.5 per cent), cattle (14.7 per cent) and camels (55.5 per cent). Cysticercus tenuicollis was found to be most prevalent in goats (34.2 per cent), followed by sheep (21.4 per cent) and cattle (0.1 per cent). Out of 4844 cattle examined, less than 2 per cent haboured Cysticercus bovis cysts; while Cysticercus ovis cysts were found in sheep (1 per cent) and goats (0.8 per cent).
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Cerebral cysticercosis: documentation of natural history with CT.
The purpose of this study was to describe the natural history of untreated cysticercosis as monitored by cranial computed tomography (CT) and correlate it when possible with the pathologic stage of the disease noted at surgery. Serial CT was performed in 113 patients; two to four scans were obtained in each patient. Correlation with surgical specimens and clinical presentation is given. In the early, acute stage, focal nonenhancing areas of edema progress to homogeneously enhancing lesions. In the chronic phase, beginning a few months after infestation, nonenhancing cysts are seen, which later demonstrate ring enhancement. Lesions may then completely resolve or may resolve only to appear later as punctate calcifications. This radiologic progression suggests the need to reevaluate current concepts in therapy and diagnosis of this disorder. Studies on therapeutic efficacy should be based on both the improvement of clinical symptoms and evidence of lesion regression at CT.
Brain Diseases↗
Ocular cysticercosis--a profile.
A retrospective study was conducted on all histopathologically proven cases of ocular cysticercosis spanning a decade in a tertiary referral centre of North India. The symptomatology, presentation, complications and treatment therapies of 18 of these patients are discussed. The most common age group to be affected was 11-20 years (50%), while the most common site involved was subconjunctival (78%), followed by lid (11%). Spontaneous extrusion was documented in three cases. Medical treatment with albendazole under the cover of corticosteroids was found to be a useful adjunct to surgical excision.
Adolescent↗
Ocular and orbital cysticercosis in hogs.
The prevalence of cysticercosis in hog muscles was correlated with oculo-orbital prevalence, and histologic characteristics of changes in the parasite and hog were observed. The orbital contents, globe, and eyelids of 39 hogs affected with Cysticercus cellulosae were examined. Thirty-seven parasites were found: 35 within the orbit and two intraocular. Twenty parasites with adjacent host tissue were studied histologically. Inflammatory infiltrates ranging from diffuse lymphoplasmacytic to dense granulomas were seen in 16 cysticerci. The scolex was unaltered in all specimens.
Animals↗
Spontaneous radiographic disappearance of cerebral cysticercosis: three cases.
We demonstrate spontaneous resolution of cysticercosis cysts in CTs of three patients. This benign course has not been emphasized previously and should be considered prior to surgical intervention or institution of other treatments.
Adult↗
A new immunologic test for CNS cysticercosis.
A new radioimmunoassay for cerebral cysticercosis was studied in 70 patients. The assay showed nearly 100% sensitivity for ventricular cysts or meningitis, 86% sensitivity for multiple parenchymal cysts, and a false-positive rate of 7%. Both serum and CSF antibody levels were useful diagnostically, and the contribution of both improved accuracy. In some patients, there was endogenous CNS production of IgG against the cysticercus antigen, which leads to elevated CSF levels and normal serum levels. Patients with high CSF total IgG levels may show false-positive CSF antibody elevation with normal serum levels.
Antibodies↗
Cysticercosis presenting as a subdural hematoma.
We describe a patient with a history of cerebral cysticercosis who presented with signs and symptoms of increased intracranial pressure; CT showed what seemed to be a subdural hematoma. At operation, the "hematoma" proved to be a subdural collection of multiple cysticercal cysts. This is the first report of this complication.
Adult↗
Cerebral cysticercosis: occurrence in the immigrant population.
Six cases of cerebral cysticercosis have been diagnosed at the Neurological Institute of New York during the past 18 years. Three recent cases are discussed, with emphasis on the variability of signs and symptoms and the best available diagnostic techniques. One must have a high index of suspicion when evaluating patients who have immigrated to the United States from endemic areas, although the disease may be acquired through food contaminated by carriers in nonendemic areas. Conventional radiography (e.g., plain films and pneumography) and, more recently, computerized tomography are the most effective tests to confirm this diagnosis. Cerebrospinal fluid and serum eosinophilia and indirect hemagglutination titers are nonspecific but occasionally helpful. Therapy is currently confined to surgical excision of lesions where possible and symptomatic treatment otherwise.
Adolescent↗
Fourth ventricular cysticercosis.
This is a review of the clinical presentation and results of surgical treatment of 25 cases of cysticercosis of the 4th ventricle. All of the patients presented with hydrocephalus and, after shunting, dilatation of the 4th ventricle persisted while the supratentorial ventricular system returned to its normal size. We propose that, after a shunt procedure is performed, early direct surgical excision of the parasite should be done. Good or excellent results were achieved in 81.4% of the patients. Associated arachnoiditis and vasculitis were the major causes of poor outcomes.
Adult↗
Intraventricular cysticercosis.
The authors review their experience with 21 cases of intraventricular cysticercosis, which corresponded to 28% of all cases of neurocysticercosis in their department during an 18-month period. The surgical approach depends on the cyst's location; one uses the transcortical microsurgical approach to reach the lateral ventricles, the transcortical or transcallosal approach to reach the 3rd ventricle, and direct exploration to reach the 4th ventricle. Cysticercus cysts should be removed because they may produce acute or chronic hydrocephalus and, if the parasite dies within the ventricles, it will generate an inflammatory reaction with local and generalized ventriculitis, which produces irreversible neurological damage.
Adult↗
[Involvement of the central nervous system in cysticercosis].
The involvement of the central nervous system in cysticercosis was demonstrate as an incidental finding in a frequence of 0,3% in 4000 autopsied cases. Most of the 12 patients came from rural areas of the State of Bahia. The low frequence compared to other sites reported in Brasil shows that the neurcysticercosis does not represent an important problem in Bahia. The host tissue response observed was represented by a chronic fibrosing inflammatory type of reaction. This study points out the importance of the methenamine silver stain (Grocott) in the identification of the degenerated embryo inside the fibrous and/or calcified lesions.
Adult↗
[Pseudohypertrophic myopathy caused by cysticercosis. Report of a case].
A 25 years old woman was admitted with a history of apparent hypertrophy of the calves, specially on the left, slight pain in the legs and difficulty in walking. Electromyography showed giant motor unit potentials with complete interference pattern. Biopsy of both gastrocnemii was performed revealing a cysticercus among inflammatory infiltrate and changes of the muscle fibers. Review of the literature disclosed 12 other reported cases. The age ranged from 10 to 35 years with a median of 25 years. Pseudohypertrophic myopathy due to cysticercosis has been found twice more common in males than in females. History of epilepsy and muscle pain occurs in about one half of the cases and muscle weakness in about one third of them. Usually there is simultaneous involvement of the upper and lower limb girdles. Myotonia is rare but subcutaneous nodules are frequently found. Our case is unique in the literature in which the pseudohypertrophy was confined to the legs and electromyography showed giant motor unit potentials. The pathogenesis of this condition is discussed and attention is called to the differential diagnosis with other pseudohypertrophic muscular conditions such as pseudohypertrophic muscular dystrophy, myotonia congenita, trichinosis, hypothyroidism, amyloidosis and glycogenosis of type I (Pompe's disease) in its juvenile form.
Adult↗
[Comparative study of immunoenzyme tests ELISA-G and ELISA-M, indirect immunofluorescence, and complement fixation in the diagnosis of human cysticercosis].
A comparative study of four immunological tests used for anti-Cysticercus antibodies detection--Enzyme-Linked ImmunoSorbent Assay IgG (ELISA-G) and IgM (ELISA-M), indirect immunofluorescence (RIFI) and complement fixation (RFC)--was made in serum and cerebrospinal fluid (CSF). 539 patients with symptoms suggesting cysticercosis, 450 relatives of these patients and 133 normal people (control group) were examined. 1122 serum samples and 120 CSF samples were analysed by ELISA-G and RIFI, 83 sera and 60 CSF also by RFC, and 28 CSF by ELISA-M. 5.2% serum samples were reagent in ELISA-G and RIFI, and 3.5% of them had discordant results. All control group sera were negative. The same tests in CSF were positive in 16.7% and had discordant results in 7.5%. ELISA-G and RIFI in serum and CSF had concordant results in 89.6% (17.7% were positive). ELISA-G, RIFI and RFC had concordant results in 54.2% sera (16.9% positives) and in 81.7% CSF (11.7% positives). When ELISA-G and RIFI were negative, RFC was positive in 41.0% sera and 11.7% CSF. ELISA-G and ELISA-M had concordant results in 78.6% CSF. When these results were discordant ELISA-G was positive in 10.7% and ELISA-M in another 10.7%. It is necessary to use concomitantly several immunological tests for anti-Cysticercus antibodies detection in serum and in CSF, in attempting to reach correct diagnosis.
Animals↗
Cysticercosis in epileptic patients of Mulungu do Morro Northeastern Brazil.
With the aim to study the magnitude of infection by the metacestode of Taenia solium in a population of epileptic patients in the arid region of Bahia, Northeastern Brazil, we examined 200 consecutive cases who attended an ambulatory clinic in the disctrict of Mulungu do Morro. Sixty-six of the patients had a diagnosis of epilepsy. From them 10 (15.2%) presented antibodies against a specific fraction of antigens in Western blot, and 4 (6.0%) had circulating parasite products, as tested by capture ELISA. Only 1 case was positive for antibodies and antigens. We found that the frequency of seropositivity was related to the time without epileptic seizure. We conclude that cysticercosis is endemic in the region of Mulungu do Morro and that it is related to a benign form of epilepsy.
Adolescent↗
[Prevalence of bovine cysticercosis in the state of São Paulo (Brazil)].
A retrospective study of Cysticercus bovis in cattle raised and slaughtered in the State of S. Paulo, Brazil, during the year of 1986, was undertaken on the basis of official records of the Brazilian Meat Inspection Service. The analysis of its special distribution was carried out in accordance with the political-administrative division adopted by the State Government, composed of 11 Administrative Regions (ARs) and one Metropolitan Region (MR), subdivided into 42 Governmental Regions (GRs), totaling 572 municipalities. The prevalence rates of each political-administrative unit were statistically compared using the "Z" test of two proportions. From records relating to 896,654 head, 48,957 cases of cysticercosis were detected, equivalent to a prevalence of 5.5% in the State. The prevalence results were obtained for 385 municipalities, in 42 GRs, 11 ARs and in the MR. Statistically significant prevalence values were observed in 97 municipalities, in 14 GRs and 4 ARs.
Animals↗
Taenia crassiceps cysticercosis: protective effect and immune response elicited by DNA immunization.
The nucleotide sequence of a protective recombinant antigen of Taenia crassiceps cysticerci present in all stages of Taenia solium (KETc7), cloned into pcDNA3 plasmid with the signal peptide sequence of the beta-glycan receptor (pTc-sp7), has been shown to be effective in protecting mice against experimental infection of T. crassiceps. To explore further the possibilities of this form of immunization and the immune response induced, mice were injected intramuscularly (i.m.) or intradermally (i.d.) with 3 doses of pTc-sp7. Similar levels of resistance were found using either i.m. or i.d. immunization. Spleen cells from i.d. and i.m. DNA immunized mice induced a specific T-cell response to T. crassiceps antigens and to a synthetic peptide from the immunogen itself (GK-1). Proliferated cells were especially enriched in CD8+ CD4- T-lymphocytes. A clear increase in the percentage of CD3+ cells that produce gamma-interferon and interleukin-2 was detected when measuring the intracellular cytokine production, an indication of the pTc-sp7 capacity to induce an effective cellular response. These results provide encouraging information on the use of KETc7 in the prevention of cysticercosis as well as a first insight into the characterization of the immune response induced by pTc-sp7 that hints to the relevance of cellular immunity in protection.
Animals↗
Can Taenia solium latent post-oncospheral stages be found in muscle tissue of cysticercosis-infected pigs (Sus scrofa)?
The existence of latent Taenia solium post-oncospheral stages in the tissues of infected pigs has been postulated. To assess whether such structures exist and can be detected, we examined muscle samples from cysticercosis-infected and uninfected pigs. Pork samples were homogenized, centrifuged, and resuspended in saline solution. Round microscopic structures of approximately 10 microm with variable refringence were found in the pellets of all samples from both infected and uninfected pigs. These became homogeneously red after staining with Sudan IV and disappeared after ether extraction. The only difference between samples from infected and uninfected pigs was the presence of inflammatory cells and tissue necrosis debris in the former group. Taenia solium oncospheres were stained and observed for comparative purposes, before and after inoculation into pork. Control oncospheres were ellipsoidal, had nucleated basophile cells in their interior, and showed red aggregates on their surfaces when stained with 3% Sudan IV. While rounded microscopical structures similar to those previously reported were found, these differed morphologically from oncospheres, were of a lipid nature, and occurred in both infected and uninfected animals. No evidence supporting the presence of latent post-oncospheral stages of Taenia solium was generated in this series of experiments.
Animals↗