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PubMed2007

Nitric oxide contributes to host resistance against experimental Taenia crassiceps cysticercosis.

The immune mechanisms that underlie resistance and susceptibility to cysticercosis are not completely understood. In this paper, using susceptible BALB/c mice and resistant STAT6-/-BALB/c mice, we have analyzed the role of nitric oxide (NO) in determining the outcome of murine cysticercosis caused by the cestode Taenia crassiceps. After T. crassiceps infection, wild-type BALB/c mice developed a strong Th2-like response, produced high levels of IgG1, IgE, IL-5, IL-4, and discrete levels of NO, and remained susceptible to T. crassiceps infection. In contrast, similarly infected BALB/c mice treated with N(omega)-nitro-L-arginine methyl ester (L-NAME, an inhibitor of NO synthase) mounted a similar immune response but with lower levels of NO and harbored nearly 100% more parasites than N(omega)-nitro-D-arginine methyl ester (D-NAME, inactive enantiomer)-treated mice. To further analyze the role of NO in murine cysticercosis, we treated STAT6-/-male mice (known to be highly resistant to T. crassiceps) with L-NAME during 8 weeks of infection. As expected, STAT6-/-mice mounted a strong Th1-like response, produced high levels of IgG2a, IFN-gamma, and IL-17, whereas their macrophages displayed increased transcripts of tumor necrosis factor (TNF)-alpha as well as inducible nitric oxide synthase (iNOS) and efficiently controlled T. crassiceps infection. However, STAT6-/-male mice receiving L-NAME mounted a similar immune response but with lower iNOS transcripts concomitantly with decreased levels of NO in sera and displayed significantly higher parasite burdens. These findings suggest that macrophage activation and NO production are effector mechanisms that importantly contribute in host resistance to T. crassiceps infection. The immune mechanisms that underlie resistance and susceptibility to cysticercosis are not completely understood. In this paper, using susceptible BALB/c mice and resistant STAT6-/-BALB/c mice, we have analyzed the role of nitric oxide (NO) in determining the outcome of murine cysticercosis caused by the cestode Taenia crassiceps. After T. crassiceps infection, wild-type BALB/c mice developed a strong Th2-like response, produced high levels of IgG1, IgE, IL-5, IL-4, and discrete levels of NO, and remained susceptible to T. crassiceps infection. In contrast, similarly infected BALB/c mice treated with N(omega)-nitro-L-arginine methyl ester (L-NAME, an inhibitor of NO synthase) mounted a similar immune response but with lower levels of NO and harbored nearly 100% more parasites than N(omega)-nitro-d-arginine methyl ester (D-NAME, inactive enantiomer)-treated mice. To further analyze the role of NO in murine cysticercosis, we treated STAT6-/-male mice (known to be highly resistant to T. crassiceps) with L-NAME during 8 weeks of infection. As expected, STAT6-/-mice mounted a strong Th1-like response, produced high levels of IgG2a, IFN-gamma, and IL-17, whereas their macrophages displayed increased transcripts of tumor necrosis factor (TNF)-alpha as well as inducible nitric oxide synthase (iNOS) and efficiently controlled T. crassiceps infection. However, STAT6-/-male mice receiving L-NAME mounted a similar immune response but with lower iNOS transcripts concomitantly with decreased levels of NO in sera and displayed significantly higher parasite burdens. These findings suggest that macrophage activation and NO production are effector mechanisms that importantly contribute in host resistance to T. crassiceps infection.

Animals↗
PubMed2001

Subretinal cysticercosis.

BACKGROUND: [corrected] Cysticercosis is a parasitic infestation of different body organs by Cysticercosis cellulosae, a larval form of the helminth, Taenia solium, known commonly as pork tapeworm. Ocular involvement of cysticercosis is most common. Other sites of infestation include the central nervous system, subcutaneous tissue, skeletal muscles, and heart muscle. Patients with ocular cysticercosis may be asymptomatic or suffer mild to severe vision loss. CASE REPORT: A patient presented with painless vision loss secondary to a parasitic infection by presumed subretinal cysticercosis. The clinical appearance, differential diagnosis, and management of subretinal cysticercosis are discussed. CONCLUSION: Prompt diagnosis and referral to a retinal surgeon are essential for the successful treatment of this condition.

Adult↗
PubMed1992

Cerebral cysticercosis as a risk factor for stroke in young and middle-aged people.

BACKGROUND AND PURPOSE: A probable association between cerebral cysticercosis and susceptibility to stroke, especially among young and middle-aged patients, has been reported. We examined the association between cerebral cysticercosis and stroke and the possible factors causing this association. METHODS: In 169 stroke patients (75 males and 94 females) under 65 years of age admitted to our neurology department, we evaluated the following possible risk factors: arterial hypertension, diabetes, cardiac disease, hyperlipidemia, smoking, alcohol abuse, and cerebral cysticercosis. In 169 control patients under 65 years of age matched by sex and age, we evaluated the same possible risk factors for stroke. RESULTS: In the univariate matched analyses, the frequencies of cerebral cysticercosis (p < 0.001), arterial hypertension (p < 0.001), cardiac disease (p < 0.001), hyperlipidemia (p < 0.05), and alcohol abuse (p = 0.05) were higher in the stroke patients than in the control patients. After controlling for possible confounding factors, we found that arterial hypertension (p < 0.001), cardiac disease (p < 0.001), and cerebral cysticercosis (p < 0.001) were independent risk factors for stroke. CONCLUSIONS: Cerebral cysticercosis should be considered a risk factor for stroke in young and middle-aged individuals.

Adolescent↗
PubMed2002

Taeniasis and cysticercosis prevalence in a small village from Northeastern Brazil.

UNLABELLED: Although not considered as an endemic region, the Northeast of Brazil has the necessary conditions for the development of taeniasis-cysticercosis complex. In a previous paper, we demonstrated that Mulungu do Morro municipality, in the State of Bahia, has a high seroprevalence to cysticercosis in epileptic patients. OBJECTIVE: to determine the prevalence of taeniasis and positive cysticercosis serology in the population of Mulungu do Morro. METHOD: blood and stool samples were collected from a random sampling of the population, by family. The identification of antibodies against T. solium cysticerci was made by EITB and T. solium antigens were identified using a polyclonal antibody-capture ELISA. RESULTS: the cysticercosis seroprevalence was 1.6% (C.I. = 0.8 to 2.8%) and the taeniasis prevalence 4.5% (C.I. = 3.0 to 6.5%). Seropositivity to cysticercosis was higher among those who lived in a house of a person testing positive for coproantigen, p=0.017. CONCLUSION: our results demonstrate that the taeniasis-cysticercosis complex is endemic in Mulungu do Morro. We believe that all areas in the world with the same socio-economic and sanitary characteristics are likely to have high prevalence of this parasite.

Adolescent↗
PubMed1998

Time-response curve of oxfendazole in the treatment of swine cysticercosis.

Human Taenia solium cysticercosis is a major cause of epilepsy in developing countries, and porcine infection causes widespread economic losses because of infested pork. Recently, the use of oxfendazole (OFZ) for porcine cysticercosis provided, for the first time, an effective, single-dose treatment. We performed a controlled study to determine the time required between treatment with a single dose of OFZ and the death of cysticerci to define its applicability as preslaughter treatment or as a field control measure. Twenty naturally infected pigs were included in this study. Sixteen received a single dose (30 mg/kg) of OFZ, and were killed in groups of four at one, two, four, and 12 weeks after treatment. Four untreated controls were killed at week 12. No adverse reactions to OFZ were noted. A clear decrease in viability and number of cysts was evident after the first week after therapy, but even at week 4 some viable cysticerci were found in all samples. Twelve weeks after treatment, all meat appeared clear and only minuscule scars remained, except in one animal that had viable brain cysts. This study confirms the efficacy of a single dose of 30 mg/kg of OFZ for porcine cysticercosis but demonstrates that preslaughter treatment of pigs with OFZ will not be useful in controlling cysticercosis. The inclusion of porcine treatment with OFZ in mass cysticercosis control programs is, however, highly promising because it is a simple, effective, inexpensive, and potentially sustainable method for decreasing the porcine reservoir of cysticercosis in disease-endemic countries.

Animals↗
PubMed2001

Cysticercosis in Indonesia: epidemiological aspects.

Cysticercosis caused by the larval stage, cysticercus or cysticerci, of the pork tapeworm Taenia solium was recognized at first in Bali and in Paniai District, Irian Jaya (Papua), Indonesia in the 1970s. In the 1990s a rapid increase in the number of the cases of epileptic seizures and burns in Jayawijaya district, eastern Papua, was observed. There were a total of 1,120 new cases of burns (7.0%) and 293 new cases of epileptic seizures (1.8%) from 15,939 local people during 1991-1995. Both histopathological examination and mitochondrial DNA analysis of resected cysts from patients and pigs revealed cysticerci of T. solium. Antibody responses highly specific to cysticercosis were revealed in approximately 67% and 65% of persons respectively with epileptic seizures and with subcutaneous nodules. Therefore, most cases of epileptic seizures and burns were considered to be associated with cysticercosis in Papua. Additional serologically data from Bali showed that 13.5% of epileptic seizures (10/74) and 12.6% of asymptomatic individuals (94/746) were supposed having been exposed to T. solium. Histopathological evaluation of 80,000 tissue samples in East Java revealed that nine were cysticercosis. All cases were non-moslems and from two ethnic groups, Chinese and Balinese. Epidemiological data on cysticercosis are not available from other provinces of Indonesia, although cases of cysticercosis are occasionally reported. Therefore, other intensive epidemiological studies are strongly recommended, especially covering the eastern part of Indonesia.

Adult↗
PubMed1989

Clinical evaluation of the therapeutic efficacy of praziquantel against human cysticercosis.

Thirty-three patients with confirmed cysticercosis, with or without cerebral involvement, were treated with praziquantel at a daily dose of 75 mg/kg tid for 3 to 10 consecutive days and evaluated for tolerance and therapeutic effects. For dermal cysticercosis, a daily dose of 75 mg/kg tid for 3 days is effective. The nodules disappeared in one to 12 months after treatment. Twenty out of 33 patients with cysticercosis had cerebral cysticercosis. Among these 20 cases, 13 had epileptic seizures, 6 had a combination of both epileptic seizures and intracranial hypertension, and one had headache. The efficacy of the treatment of cerebral cysticercosis was assessed by the frequency of convulsions before and after treatment, and by the disappearance or decreased densities of the cystic lesions at brain CT scanning (6 months follow up). A daily dose of 75 mg/kg tid for 7 to 10 days (total 525 to 750 mg/kg) seems to be effective for the treatment of cerebral cysticercosis. The concomitant oral administration of dexamethasone during the course of treatment was effective for preventing and minimizing side effects. Praziquantel was very well tolerated.

Adult↗
PubMed1982

[Economic losses due to cysticercosis in cattle].

Based on the data collected by Large Fattening Houses, economic consequences of cysticercosis in cattle reared on the farm Ceské Velenice (district Jindrichův Hradec) were evaluated. On this farm, a mass occurrence of cysticercosis was observed throughout the period of 1975 to 1977, a partial occurrence in 1978, as after-effect from the previous period. The number of infected bulls was calculated from the number of animals in which cysticercosis was detected in the slaughter-houses. The highest percentage of bulls suffering from cysticercosis at the time of purchase was found in 1976-69.1%; beginning the April of 1976, the occurrence amounted almost to 100%; the decrease started in the April of 1977. Cysticercosis affected the average realization price which in 1976 was as low as 8.56 Kcs (Czechoslovak crowns) per one kg of live weight. In that year, financial losses amounted up to 6.93 Kcs per 1 kg of live weight in all sold animals. The total direct financial losses due to cysticercosis in the bulls on this farm equalled 2,567,799 Kcs, till the year 1978 when this parasitosis was eradicated.

Animals↗
PubMed2003

Cysticercosis as a major risk factor for epilepsy in Burundi, east Africa.

PURPOSE: Human cysticercosis is a direct consequence of infection by Taenia solium larvae (Cysticercus cellulosae). Results of studies on the impact of neurocysticercosis on epilepsy in Africa are inconsistent. The objective was to evaluate the role of cysticercosis in epilepsy in Burundi. METHODS: A prevalent matched case-control design was used in the Kiremba area, Burundi, between March and April 2001. One case with epilepsy was matched to two control subjects, according to their age. Cases were subjects who had shown at least two unprovoked epileptic seizures within a 24-h time range and who lived in the Kiremba area. The control subjects also lived in Kiremba and had neither neurologic illness nor kinship with the people with epilepsy. Seropositivity for cysticercosis was the exposure variable. Three hundred twenty-four prevalent cases, with onset of epilepsy between 1950 and 2000, and 648 age-matched controls were included. RESULTS: This study found a link between cysticercosis infestation and the occurrence of epilepsy (odds ratio, 3.8; 95% confidence interval, 2.5-5.1). CONCLUSIONS: The study highlighted the importance of cysticercosis in the area of Kiremba, as 31.5% of the control subjects screened positive for this parasite. The attributable risk for cysticercosis was 50% (95% confidence interval, 42-57) in this population.

Adolescent↗
PubMed1998

Ultrasonological characteristics of extraocular cysticercosis.

Cysticercosis is a common ophthalmic parasitosis wherein humans are the intermediate hosts in the life cycle of the tape worm Taenia solium. While intraocular cysticercosis is more common and is more readily diagnosed clinically, recognition of extraocular cysticercosis needs supplementary imaging. Computed tomography (CT) and magnetic resonance imaging (MRI) have been extensively used to diagnose and characterize neurocysticercosis. Since the orbit is easily accessible to ultrasonography (USG), we evaluated its role in the diagnosis and management of extraocular cysticercosis. Serial A- and B- scan ultrasonograms from 24 patients with extraocular cysticercosis were analyzed to determine features at various stages of evolution of the lesion and an attempt was made to classify the lesion on this basis. Of 24 patients, 23 had a cyst clearly demonstrable by USG: 22 within or attached to an extraocular muscle (with or without myositis) and one free in the orbit. One patient had an optic nerve cyst not detected by USG but by CT scan. Cysts at various stages of evolution were found - viable, degenerating and inactive. The therapeutic response of the cyst to treatment with oral albendazole could be effectively studied and monitored by sequential USG. Orbital ultrasound is a practical, precise and cost-effective imaging modality to diagnose, manage and monitor extraocular cysticercosis, although it can not completely replace CT and MRI.

Journal Article↗
PubMed1982

Therapeutic Trial Of Praziquantal (Embay 8440; Biltricide(R)) On The Dermal And Cerebral Human Cysticercosis.

A total of 28 adult cases who were confirmed cysticercosis with or without cerebral involvements were treated with praziquantel at the daily dose of 3 x 25 mg/kg for 3 to 7 consecutive days and was evaluated for tolerance and therapeutic effects in the trials clinically performed.The assessment of drug efficacy of praziquantel in the dermal cysticercosis was made by comparing the numbers of cysticercus nodules and histopathological findings of the biopsied parasites by means of light, scanning and transmission electron microscope. In the cerebral cysticercosis, the assessment was considered by the frequency of the episodes of convulsive seizure before and after treatment with praziquantel and by the findings of the disapearance or decreased densities of the lesions in C.T. scan in comparison with those of before and after treatment. The results were as follows: 1. The cysticerci in the subcutaneous tissues began to disappear within one month of drug administration of 3 x 25 mg/kg praziquantel over 3 to 7 days. Within 3 to 6 months most of the cysticerci had disappeared, although in some case a small number of cysticercus nodules remained even one year after treatment. 2. Histological observation of the cysticerci biopsied at different times during the course of treatment revealed that morphological changes were already taking place within two weeks after the treatment. At the early stage of the treatment, small vacuoles were scattered along the basement layer in the tegumental syncytium of the scolex and neck regions. In the scanning electron microscopic observation, marked surface changes were present in the neck region with many bleb-like structures formed by the bursting of the large vacuoles in the tegumental syncytium. In the specimens biopsied at 2 or 5 weeks after treatment, the degenerations and necrosis of the tegumental syncytium were seen in all parts of cysticercus. 3. In 12 cases of cerebral cysticercosis treated with praziquantel at the daily dose of 3 x 35 mg/kg for 3 or 4 consecutive days, there were no ceasing of the convulsive seizures during the 6 months follow-up. Among them 9 cases were given again the same doses of the drug for 4 or 7 days. In 7 of 9 cases, no more convulsive seizure was experienced over one or two years after the second time. At the same treatment the lesions of the brain C.T. scan disappeared, decreasd in size or calcified after treatment. In other 3 cerebral cysticercosis cases, complete cure was also obtained after the oral medication of praziquantel at the daily dose of 3 x 25 mg/kg for 7 consecutive days. 4. In the treatment of cerebral cysticercosis with praziquantel, it was found that the concomitant oral medication of dexamethasone during the course of treatment was effective for preventing and minimizing the side-effects.

Journal Article↗
PubMed2002

Determination of specific IgG4 for diagnosis and therapeutic evaluation of cerebral cysticercosis.

OBJECTIVE: To probe the significance of specific IgG4 in sera of patients with cerebral cysticercosis for diagnosis and therapeutic evaluation. METHODS: Specific IgG4 in sera of patients with cerebral cysticercosis was assessed using colloidal gold-labeled mouse-anti-human IgG4 McAb as probe. The results were compared with the CT image manifestation. RESULTS: The specific IgG4 positive rate in sera of patients with cerebral cysticercosis was 97.8%, whereas sera from patients with other kinds of parasitosis or central nerve system disease and the control group were all negative, except for a weak cross-reaction of sera from patients with hepatic echinococoosis. The determination of specific IgG4 in sera of patients with cerebral cysticercosis during different times of treatment showed that along with an increase in treatment time and improvement of clinical symptoms, specific IgG4 level gradually decreased. The positive rate and intensity of specific IgG4 in sera from patients with cerebral cysticercosis were consistent with the number of cysticercus parasites in the brain and pathologic changes, such as survival, disintegration, death and calcification. Survival of cysticercus in the brain was objectively evaluated using this technique. CONCLUSIONS: The determination of specific IgG4 in sera is a practical method for diagnosis and therapeutic evaluation of cerebral cysticercosis.

Animals↗
PubMed2001

An epidemiological study of Taenia solium cysticercosis in a rural population in the Bolivian Chaco.

A survey of 100 rural households in a village in the Chaco region of Bolivia revealed a serious problem of Taenia solium cysticercosis, with a seroprevalence of 99/447 (22%) in humans and 102/273 (37%) in pigs. Risk factors for humans were being in older age groups, absence of sanitary facilities, poor formal education and inability to recognise infected pork. Significant risk indicators were a history of seizures and the reported elimination of worms in the faeces. Risk factors for pigs were being in older age groups and absence of sanitary facilities in the owner's house. The proportion of households with evidence of human cysticercosis was similar for those who owned pigs (48%) and those that did not (55%). This unexpected finding was attributed to the high overall prevalence of cysticercosis in pigs and the probability that everyone, regardless of pig-ownership, had ample opportunity to become infected in such communities. The main recommendation for reducing the prevalence of human cysticercosis was to provide more effective education campaigns, aimed at preventing both T. solium infection and cysticercosis.

Adolescent↗
PubMed2003

Intraocular cysticercosis: clinical characteristics and visual outcome after vitreoretinal surgery.

PURPOSE: To report the clinical characteristics of, discuss the surgical options for, and analyze the factors affecting the anatomic and visual outcome of intraocular cysticercosis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Forty-five eyes of 44 Indian patients with posterior segment intraocular cysticercosis. METHODS: The charts of 45 eyes, in which intraocular cysticercosis was removed by vitreoretinal surgery (either transscleral or transvitreal), were reviewed. MAIN OUTCOME MEASURES: These included the postoperative retinal status and the best-corrected Snellen visual acuity. RESULTS: Intraocular cysticercosis was present in the vitreous cavity of 27 eyes (60%) and in the subretinal space of 18 eyes (40%). Anterior segment inflammation was seen in 13 eyes (28.8%) and vitreous inflammation in 38 eyes (84.4%). Retinal detachment was observed in 22 eyes (48.8%), with proliferative vitreoretinopathy in 13 eyes (59.09%). Subretinal cysts anterior to the equator (4 eyes) were removed transsclerally, whereas subretinal cysts posterior to the equator and intravitreal cysts (41 eyes) were removed transvitreally. The mean follow-up was 10.5 months. At the last follow-up, the retina was attached in 39 eyes (86.6%); visual acuity of >/=5/200 was achieved in 67.5%. CONCLUSIONS: Current vitreoretinal surgical techniques enable removal of intraocular cysticercosis in all cases, with reattachment of the retina in 86.6% and recovery of ambulatory vision in approximately 67% of cases.

Adolescent↗
PubMed2006

[Cysticercosis contracted in metropolitan France].

INTRODUCTION: All cases of cysticercosis diagnosed in France are thought to be imported. Our case report concerns a 48-year-old man who has never left Europe, in whom we diagnosed subcutaneous cysticercosis. CASE: Histologic examination of the subcutaneous nodule extracted from this patient's abdominal wall showed cysticercosis. He has never left Europe. Various imaging techniques showed no other localizations of this infection. Neither he nor any members of his family carried adult Taenia solium. DISCUSSION: We present an exceptional case of autochthonous cysticercosis. It is unlikely to be a larva of Taenia solium, since this adult tapeworm has not been seen in mainland France for a very long time. On the other hand, Taenia crassiceps cestodes parasitize the digestive tract of the fox in Auvergne and may occasionally cause cysticercosis in humans.

Animals↗
PubMed2003

A seroepidemiological study of human cysticercosis in West Cameroon.

We studied the occurrence of human cysticercosis in 4993 individuals from three rural communities of Menoua Division, West Province of Cameroon. Circulating antigens of Taenia solium metacestodes were detected in 0.4%, 1.0% and 3.0% of the serum samples taken in Bafou, Bamendou and Fonakekeu, respectively, and examined using a monoclonal antibody-based enzyme-linked immunosorbent assay. This test detects only carriers of living cysticerci and gives thus a good idea of the presence of active cysticercosis. The percentage of persons infected with cysticercosis increased with age. Twenty-two of the 34 seropositives underwent computed tomography (CT) of the brain. Thirteen of them were CT-scan positive, which shows that neurocysticercosis was present in 59.1% of the tested seropositive persons. No living cysticerci were detected among 20 seronegative people. About 20.6% of the seropositives had a history of or current taeniasis against only 1.9% of the seronegatives. Based on these figures and on the data on porcine cysticercosis (prevalence: 11%) and human taeniasis (prevalence: 0.13%) collected in the same region, we conclude that T. solium cysticercosis is an endemic, but overlooked public health problem in West Cameroon.

Adolescent↗
PubMed1999

Cysticercosis in Nepal: a histopathologic study of sixty-two cases.

Human cysticercosis, an infection caused by larvae of Taenia solium, is a major public health problem in many developing countries. Sixty-two of 23,402 biopsy cases have been detected as cysticercosis in the last 5 years in Patan Hospital. Most (82%) of the patients presented with solitary skin nodules, another 10% with nodules in the oral mucosa, and 8% in the breast. Forty cases were identified from the Kathmandu valley and the rest from outside Kathmandu. Most patients were younger than 30 years of age (mean, 21+/-11 years). Statistically, there was no difference between males (0.28%) and females (0.24%). The average size of cysticercosis was 19 mm in diameter, and the histology of cysticercosis showed fibrous walled cysts covered by several layered epithelioid cells with a few Langhans' giant cells and infiltration of eosinophils without caseous necrosis. These cysticercosis findings from an endemic area will be helpful for doctors who examine immigrant patients in nonendemic areas.

Adolescent↗
PubMed2007

Evaluation of immunodiagnostics for toxocarosis in experimental porcine cysticercosis.

We assessed whether immunodiagnostic tests for cysticercosis can cross-react with the currently available immunodiagnostic tests for Toxocara canis in an established animal model for cysticercosis infection in pigs, known host for Toxocara. We examined by TES-enzyme-linked immunosorbent test and immunoblot assay for toxocarosis and cysticercosis the baseline and final follow-up sera of 10 pigs, before and after (3 months) infection with Taenia solium. After successful cysticercosis infection, the nine evaluable pigs became seropositive to T. solium (enzyme-linked immunoelectrotransfer blot assay), but did remain seronegative for Toxocara in both assays, documenting the lack of cross-reactivity with anti-T. solium antibodies in both T. canis assays. These findings should help clinicians better interpret serology for toxocariosis and cysticercosis in endemic areas for both helminth infections.

Animals↗