Cysticercosis

This article is about infection by the young form (cysticercus larvae) of the worms. For the organism, see Taenia solium.
Cysticercosis
Magnetic resonance image (MRI) in a person with neurocysticercosis showing many cysts within the brain.
SpecialtyInfectious disease
Symptoms1–2 cm lumps under the skin[1]
ComplicationsNeurocysticercosis[2]
DurationLong term[3]
CausesEating tapeworm eggs (fecal oral transmission)[1]
Diagnostic methodaspiration of a cyst[2]
PreventionImproved sanitation, treating those with taeniasis, cooking pork well[1]
TreatmentNone, medications[2]
MedicationPraziquantel, albendazole, corticosteroids, anti seizure medications[1]
Frequency1.9 million[4]
Deaths400[5]

Cysticercosis is a tissue infection caused by the young form of the pork tapeworm.[6][1] People may have few or no symptoms for years.[3][2] In some cases, particularly in Asia, solid lumps of between one and two centimetres may develop under the skin.[1] After months or years these lumps can become painful and swollen and then resolve.[3][2] A specific form called neurocysticercosis, which affects the brain, can cause neurological symptoms.[2] In developing countries this is one of the most common causes of seizures.[2]

Cysticercosis is usually acquired by eating food or drinking water contaminated by tapeworms' eggs from human feces.[1] Among foods egg-contaminated vegetables[1] are a major source.[7] The tapeworm eggs are present in the feces of a person infected with the adult worms, a condition known as taeniasis.[2][8] Taeniasis, in the strict sense, is a different disease and is due to eating cysts in poorly cooked pork.[1] People who live with someone with the pork tapeworm have a greater risk of getting cysticercosis.[8] The diagnosis can be made by aspiration of a cyst.[2] 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.[2] An increased number of a type of white blood cell, called eosinophils, in the cerebral spinal fluid and blood is also an indicator.[2]

Infection can be effectively prevented by personal hygiene and sanitation:[1] this includes cooking pork well, proper toilets and sanitary practices, and improved access to clean water.[1] Treating those with taeniasis is important to prevent spread.[1] Treating the disease when it does not involve the nervous system may not be required.[2] Treatment of those with neurocysticercosis may be with the medications praziquantel or albendazole.[1] These may be required for long periods.[1] Steroids, for anti-inflammation during treatment, and anti-seizure medications may also be required.[1] Surgery is sometimes done to remove the cysts.[1]

The pork tapeworm is particularly common in Asia, Sub-Saharan Africa, and Latin America.[2] In some areas it is believed that up to 25% of people are affected.[2] In the developed world it is very uncommon.[9] Worldwide in 2015 it caused about 400 deaths.[5] Cysticercosis also affects pigs and cows but rarely causes symptoms as most are slaughtered before symptoms arise.[1] The disease has occurred in humans throughout history.[9] It is one of the neglected tropical diseases.[10]

  1. ^ a b c d e f g h i j k l m n o p q "Taeniasis/Cysticercosis". WHO.
  2. ^ a b c d e f g h i j k l m n García HH, Gonzalez AE, Evans CA, Gilman RH (August 2003). "Taenia solium cysticercosis". Lancet. 362 (9383): 547–56. doi:10.1016/S0140-6736(03)14117-7. PMC 3103219. PMID 12932389.
  3. ^ a b c García HH, Evans CA, Nash TE, et al. (October 2002). "Current consensus guidelines for treatment of neurocysticercosis". Clin. Microbiol. Rev. 15 (4): 747–56. doi:10.1128/CMR.15.4.747-756.2002. PMC 126865. PMID 12364377.
  4. ^ Vos T, Allen C, Arora M, et al. (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". The Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  5. ^ a b Wang H, Naghavi M, Allen C, et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". The Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  6. ^ Roberts LS, Janovy Jr J (2009). Gerald D. Schmidt & Larry S. Roberts' Foundations of Parasitology (8th ed.). Boston: McGraw-Hill Higher Education. pp. 348–351. ISBN 978-0-07-302827-9.
  7. ^ Herrador Z, Fernandez-Martinez A, Benito A, Lopez-Velez R (5 April 2018). "Clinical Cysticercosis epidemiology in Spain based on the hospital discharge database: What's new?". PLOS Neglected Tropical Diseases. 12 (4): e0006316. doi:10.1371/journal.pntd.0006316. ISSN 1935-2735. PMC 5886389. PMID 29621234.
  8. ^ a b "CDC - Cysticercosis". Archived from the original on 2014-07-10.
  9. ^ a b Bobes RJ, Fragoso G, Fleury A, et al. (April 2014). "Evolution, molecular epidemiology and perspectives on the research of taeniid parasites with special emphasis on Taenia solium". Infect. Genet. Evol. 23: 150–60. doi:10.1016/j.meegid.2014.02.005. PMID 24560729.
  10. ^ "Neglected Tropical Diseases". cdc.gov. June 6, 2011. Archived from the original on 4 December 2014. Retrieved 28 November 2014.