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Lytic lesions of the skull due to cysticercosis are described. Encysted larvae in the subarachnoid space eroded the inner table of the skull in a 10-year-old Guatemalan male. In an area with endemic cysticercosis infections, this diagnosis should be considered when round, lytic defects are demonstrated in a skull radiograph.
A "crude" antigen prepared from the strobilate stage of Taenia saginata was tested for its suitability in the peroxidase microenzyme-linked immunosorbent assay (ELISA) for the diagnosis of T. saginata cysticercosis in cattle. Sera were tested from laboratory and pasture-reared calves experimentally infected with T. saginata as well as from cattle naturally infected by grazing on pasture irrigated with sewage effluent. The specificity of the "diagnostic" antigen was assessed using sera from laboratory-reared cattle with monospecific infections of T. saginata, T. hydatigena, Fasiciola hepatica, or gastro-intestinal nematodes, and natural infections of F. hepatica. Cross-reactions occurred in sera from all heterologous infections but the highest level occurred in cattle experimentally or naturally infected with F. hepatica. Clear diagnostic antibody levels were found in cattle experimentally infected with T. saginata but the test was not found to be reliable in individual animals with natural infections when compared with sera from cattle naturally infected with . hepatica. On a group or herd basis ELISA using "crude" antigen and taking the mean absorbance values, could be useful as an indicator of a high prevalence rate of T. saginata cysticercosis.
A case of fourth ventricle cysticercosis treated with praziquantel is presented. The disappearance of the lesion six months after the treatment was demonstrated by CT scan. A review of the literature indicates that this is a very exceptional result, because with recently intraventricular cysticercosis was considered to be non-responsive to praziquantel treatment, making surgery necessary.
Cysticercosis is the most common parasitosis affecting the central nervous system and it is endemic in many countries. Although cysticercosis is nowadays a rare disease in Spain, three of such cases have been treated with Praziquantel at the Hospital "Princesa Sofía" of León and another three at the Hospital General de Galicia of Santiago, and the six of them are reported together. The six patients presented at CT scans cysts located at different levels in the brain parenchyma, subarachnoid space and ventricular system. Praziquantel was administrated at daily dosage of 50 mg per kilogram of body weight, by oral route, distributed in three doses during 15 days. Moderate hepatotoxic effect were detected in two cases. No significant neurological disfunction was observed in any case during the treatment. The therapeutic effect on the brain cysts was evaluated in the CT scans obtained after treatment. In four cases a positive effect on the cysts was observed, but no apparent effect was noticed in the other two.
Economic losses from cysticercosis are determined by disease prevalence, grade of animals infested, potential markets, prices of cattle and treatment costs for detained carcasses. The main features of the livestock economics of Botswana and Kenya are discussed. Botswana is more dependent on meat exports than Kenya and its cattle prices are much higher. The incidence of cysticercosis at export abattoirs in Botswana and Kenya is about 8 and 20% respectively. Annual losses in Botswana now approach 0-5 million pounds, while in Kenya they are about 1 million pounds. The loss per animal slaughtered is 2-25 pounds in Botswana and 1-50 pounds in Kenya. Some implications for veterinary research in this area are examined. Blanket treatment with a drug or vaccine would only be economical where prevalence was very high. An in vivo diagnostic test would be of use mainly with high value cattle.
Taenia saginata cysticercosis was experimentally produced in 4 Soay sheep, 1 four-horned sheep and 1 Texel sheep by oral administration of eggs of the parasite. Some of these sheep were given dexamethasone therapy. The evolution of T. saginata cysticercosis in this host is characterised by a rapid immune reaction so that by 6 weeks after infection almost all the cysts were dead. There were indications that the dexamethasone therapy may have assisted establishment of the infection and to some extent, postponed the process of degeneration.
Although intramedullary spinal cord cysticercosis (IMC) is uncommon, its presence is being increasingly recognised by magnetic resonance imaging. We studied six patients from an endemic region and present the MRI features and clinical correlation of IMC. Six patients who presented with para- or quadriplegia were studied by contrast enhanced spinal MRI. Prompted by the spinal lesions, all patients underwent brain MRI. Clinical data and laboratory studies were reviewed in all patients. Definite diagnosis was established in the form of response to drug therapy (n = 4) and histopathology (n = 2). Follow-up MRI studies of spine and brain were obtained in four patients 2 months after they started medical treatment, regardless of surgery. Five patients showed fusiform and focal enlargement of the spinal cord (cervical 2, thoracic 3). Well-defined cysts with a slightly hyperintense mural nodule were identified in five patients in Ti-weighted images (T1WI). All cysts were hyperintense on T2WI and merged with the surrounding oedema. Oedema extended one to three vertebral levels above or below the cyst. Post-contrast T1WI showed well-defined, ring enhancing lesions with smooth walls in all patients. Symptoms in all patients correlated with the level of the lesions. Brain studies demonstrated lesions in just two patients. Histopathological confirmation was obtained in two patients. Follow-up spinal MRI was normal in two patients, following 2 months of treatment while residual and smaller lesions were seen in two patients. Two patients were asymptomatic and denied follow-up MRI. MRI of spinal cysticercosis were typical of and similar to those seen in cerebral lesions in our patients and corresponded to the level of symptoms. All cysts were surrounded by oedema. Two of four patients showed residual lesions after 2 months of therapy and 33 % of patients showed concomitant intracranial lesions.
We report a 40-year-old man with cysticercosis presenting as a solitary tumor in the biceps brachii muscle. Physical examination revealed an intramuscular mass and magnetic resonance imaging suggested a cyst. The histologic diagnosis was a cysticercus. Such solitary presentation of muscular cysticercosis is extremely rare with only a handful of sporadic reports in the literature.
Two peptides, HP6-2 and Ts45S-10, were used as antigens for the detection of antibodies against Taenia saginata cysticercosis in serum and meat juice samples using enzyme-linked immunosorbent assay (ELISA). Positive control samples were obtained from animals experimentally infected (serum) and from animals naturally infected (meat juice). The two peptides and a pooled preparation of both peptides were evaluated, and their cut-off points with both sample categories were calculated. ELISA results from these different peptides were compared. Sensitivity and specificity of HP6-2 using serum were calculated as being 100 and 98%, respectively, showing to be higher than the values for the other antigens used. The average optical density (OD) value for negative samples was 0.646, whereas it was 1.702 for the positive control samples. This peptide was used to examine serum samples from animals with cysts and random field serum samples. For meat juice samples the pooled peptides showed the highest sensitivity and specificity, as they were 100 and 95%, respectively. The average OD values for the negative and the positive reference meat juice samples were 0.379 and 1.291, respectively. The optimal dilution of the meat juice samples for the ELISA was very low, as it was 1:20 using the pooled peptides, compared with 1:800 serum dilution using HP6-2. To the authors' knowledge, this is the first report of a successful testing for T. saginata cysticercosis using meat juice.
Resistance and susceptibility to different parasitic diseases have been associated with the predominance of Th1- or Th2-type immune responses. In experimental murine cysticercosis a Th1 response seems to be involved in resistance, whereas Th2 activity is associated with heavy parasite intensities. To test this notion the roles of Th1- and Th2-type cytokines in infected mice were studied after treatment with anticytokine monoclonal antibodies or with recombinant murine cytokines during early stages of infection. Mice receiving anti-interleukin 10 (IL-10) carried lower parasite intensities than did control mice and developed a strong Th1-type response, whereas mice receiving anti-interferon gamma (IFN-gamma) showed a dramatic increase in susceptibility. Treatment with recombinant cytokines confirmed these results; mice receiving IFN-gamma and IL-2 showed low parasite numbers, whereas IL-10 induced a significant increase in parasite loads. Thus, the Th1-type immune response plays a fundamental role in protection against Taenia crassiceps cysticercosis, whereas Th2, at least through IL-10, favors parasite establishment.
Several biological factors are involved in susceptibility and resistance to murine cysticercosis. A substantial body of evidence implies prostaglandins as potent regulators of immune responses during parasitic diseases. Here we evaluated the role played by prostaglandin E2 in cysticercosis. Mice were treated in vivo with prostaglandin E2 or with indomethacin (a prostaglandin E2 synthesis inhibitor) before infection. Parasite growth was enhanced by prostaglandin treatment, which provoked poor Con-A responses, low Th1-type cytokines secretion, and high levels of IL-6 and IL-10. In contrast, mice receiving indomethacin showed a reduction in parasite load parallel to a strong Con-A response and high levels of IL-2 and IFN-gamma, concomitantly with a decrease in IL-4, IL-6 and IL-10 production. Indirect in vitro studies suggest that an important source of prostaglandin E2 production could be related to host's adherent cells. However, prostaglandin E2 from parasite origin cannot be discarded.
Taenia crassiceps cysticerci develop in the peritoneal cavity of BALB/cAnN mice and, to a lesser extent, in C57BL/6J mice. The mechanisms involved in the immunity to this murine cysticercosis seem to be mainly mediated by T cells. To gain further insight into the mechanisms of cysticercal immunity, the susceptibility of mice deficient in different immunologically relevant genes was compared with that of the respective wild type. Mice were classified according to the parasite load and survival after infection: highly susceptible (HS), with an increased parasite load and mortality rate (CD4-/-, TCRalpha-/-, TCRbeta-/-, RAG1-/-), susceptible, with only increased parasite load (TCRdelta-/-, BALB/cAnN), and relatively resistant, with a lower number of parasites (CD8-/-, WT). Neither specific proliferative response nor Th2 cytokine or antibody responses were observed in HS mice. These data strongly suggest that CD4+TCRalphabeta+ T cells have a critical role in the control of T. crassiceps murine cysticercosis.
Human cysticercosis and tuberculosis are endemic diseases in developing countries. Both these diseases have certain common factors of origin. We would like to present the co-existence of these infections in a 20-year-old female. She was a known case of pulmonary and ocular tuberculosis and she acquired cysticercosis of the eye and brain.
Dot-immunogold-silver staining (Dot-IGSS) and Dot-ELISA were used, with Taenia solium cyst fluid antigen, to detect specific antibodies in the sera of patients with cysticercosis. All 40 confirmed cases of cysticercosis were found to be positive when tested by 2 methods. The average titer of the sera detected by Dot-IGSS was 1:27,470, which was significantly higher than that detected by Dot-ELISA. The false positive rates were 2% and 4% in 50 healthy controls for Dot-IGSS and Dot-ELISA, respectively, with a low titer of 1:20.
A 60-year-old woman developed progressive spastic crural paraplegia and global anesthesia and global anesthesia below T10, succumbing to urinary infection and bronchopneumonia 8 months after the onset of symptoms. At necropsy, the spinal cord was completely destroyed by a necrotic intramedullary cysticercus at T8. Six cysticerci were found in the brain. A review of the 17 published cases of intramedullary cysticercosis (including this one) showed this condition to be clinically indistinguishable from spinal cord tumours. The surgical prognosis was fair in 8 of 11 operated patients. The role of hematogenous and ventriculo-ependymal pathways in the pathogenesis of intramedullary cysticercosis was examined. The topographical distribution of intramedullary cysticerci (5 cervical, 12 thoracic, 2 lumbar, none sacral) was found to be statistically proportional to the blood flow to each of these regions; this favours the hematogenous route of infestation. The low spinal cord blood flow (100 times less than that to the brain), the type of vascularization of the cord (low calibre vessels under low pressure) and peculiarities of the cord tissue (such as its harder consistency) are all thought to be contributory factors accounting for the scarcity of intramedullary cysticerci. No evidence for an ependymal route of spread could be adduced.
Fifteen metacestode antigens from Taenia saginata were defined by Laurell crossed immunoelectrophoresis and investigated for their potential use in immunodiagnosis of bovine cysticercosis. Several antigens cross reacted with those of some common cattle parasites. Three of the antigens, designated as numbers 4, 8 and 11, were selected on the basis of their restricted cross reactions and were isolated by affinity chromatography. These antigens showed high sensitivity and specificity values in the enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of bovine cysticercosis.
Serological tests (ELISA) for cysticercosis were performed on groups of schoolchildren from two rural areas of Southern Africa, Ingwavuma in Northern KwaZulu and Isilimela in the Transkei. 22 of 736 Transkeian children were serologically positive while only 8 of 677 KwaZulu children were positive. These results, when corrected for the sensitivity and specificity of the test, indicate a cysticercosis prevalence of 2.49% in the Transkeian group and 0.23% in the KwaZulu group.
A case of cerebral cysticercosis is reported in a 49-year-old female who presented with headache, nausea, and vomiting. Lumbar CSF showed the findings of mild aseptic meningitis. CT scan revealed an enlargement of the left ambient cistern and a small cystic lesion in the left frontal cortex. MRI demonstrated multilobular cysts in the left ambient cistern with enhancement of their capsules, which compressed and distorted the midbrain. The cysts were surgically excised, and histological examination of the specimen disclosed characteristic features of cysticercus with viable larva. An excellent value of MRI in the diagnosis of intracisternal cysticercosis is emphasized.