Cysticercosis



Background

  • Infection with the larval form (or cysticercus) of the pork tapeworm Taenia solium
  • Principally Latin America, Asia, and Africa
  • Infection to symptoms may take years
  • Commonest in CNS = neurocysticercosis
    • Seizures, ↑ICP , meningitis, cranial N. palsies
  • Otherwise, calcified cysts (cysticerci-encysted larvae) in muscle, skin, eyes, heart

Diagnosis

  • Dx by A) Imaging and B) Serology
    • CT sensitive for calcification
    • MRI sensitive for surrounding oedema
  • Most infections are asymptomatic & benign
  • Untreated cysticercosis with hydrocephalus or immune reactions may cause cerebral infarction

Management

  • Focus on ABCs
  • Control seizures, cerebral oedema, hydrocephalus
  • Anthelminthic therapy only if live (non-calcified) cysticerci
  • Anthelminthic therapy, kills viable cysts and provokes an inflam. response, may ↑ symptoms acutely
  • Co-administration of dexamethasone to mitigate inflam. response
  • Antihelminthics: Albendazole or Praziquantel

Prevention

  • Avoid food that is potentially contaminated by human faeces
  • Good food handling practices
Cysticercosis - From CDC site
Cysticercosis - From CDC site
Cysticercosis 1

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 16/04/22.