Cysticercosis

Other Names: Taeniasis; Neurocysticercosis; Submacular cysticercosis

Cysticercosis is an infection caused by the pork tapeworm, ''Taenia solium''.

Cause

Life cycle of Taenia solium

The condition develops when tapeworm eggs, which can be found in contaminated food, enter the body and form cysticeri (cysts). In most cases, the worms stay in the muscles and do not cause symptoms. However, symptoms may be present when the infection is found in the brain, eyes, heart or spine.

Signs and symptoms

Muscles

Cysticerci can develop in any voluntary muscle. Invasion of muscle can cause inflammation of the muscle, with fever, eosinophilia, and increased size, which initiates with muscle swelling and later progress to atrophy and scarring. In most cases, it is asymptomatic since the cysticerci die and become calcified.

Nervous system

The term neurocysticercosis is generally accepted to refer to cysts in the parenchyma of the brain. It presents with seizures and, less commonly, headaches. Cysticerca in brain parenchyma are usually 5–20 mm in diameter. In subarachnoid space and fissures, lesions may be as large as 6 cm in diameter and lobulated. They may be numerous and life-threatening.

Cysts located within the ventricles of the brain can block the outflow of cerebrospinal fluid and present with symptoms of increased intracranial pressure.

Racemose neurocysticercosis refers to cysts in the subarachnoid space. These can occasionally grow into large lobulated masses causing pressure on surrounding structures. Spinal cord neurocysticercosis most commonly presents symptoms such as back pain and radiculopathy.

Eyes

In some cases, cysticerci may be found in the eyeball, extraocular muscles, and under the conjunctiva (subconjunctiva). Depending on the location, they may cause visual difficulties that fluctuate with eye position, retinal edema, hemorrhage, a decreased vision or even a visual loss.

Skin

Main article: Cysticercosis cutis

Subcutaneous cysts are in the form of firm, mobile nodules, occurring mainly on the trunk and extremities.Subcutaneous nodules are sometimes painful.

Diagnosis

The diagnosis can be made by aspiration of a cyst. Taking pictures of the brain with computer tomography (CT) or magnetic resonance imaging (MRI) are most useful for the diagnosis of disease in the brain.An increased number of a type of white blood cell, called eosinophils, in the cerebral spinal fluid and blood is also an indicator.

Prevention

Infection can be effectively prevented by personal hygiene and sanitation

Treatment

Treatment may include medications to kill the parasites and powerful anti-inflammatory medications (steroids) to reduce swelling. In severe cases, surgery may be needed to remove the infected area.

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

• Albendazole (Brand name: Albenza®)

Treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium.

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