· Taenia solium , the pork tapeworm , inhabits the intetinal lumen of humans , its only definite host. Pigs are the usual intermediate hosts. Male acquires the infection following the eating of undercooked pork containing cysticerci.
· When human tissue is invaded by the larval form the condition is referred to as to as cysticercosis. Human cysticercosis results from ova being swallowed or gaining accesstothe human stomach by reguragitation from the person’s own adults worm . The larvae are liberated from eggs in the stomach,. Penetrate the intestinal mucosa and are carried to manu parts o the body where they develop and form custicercil .The common locations are subcutaneous tissue,
Clinical features
· Presence of adults worm in the intestine is generally asymptomatic.
· Superficially placed custs may be palpable under the skin or mucosa as pea-like avoid bodies.
· The dead larvae may invoke marked tssue response with muscular pain , weakness , fever and eosinophilia.
· Neurocysticercosis results from brain cysts. It may manifest as manifest as meningoencephalitis, epilepsy, personality changes , staggering gait , space occupying lesion stroke (due to inflammatory changes in the wall of intracranial arteries located in the vicinity of custicerci) or hydrocephalus.
Diagnosis
· Eggs and proglottids in stool .
· Soft tissue radiographs may show calcified cysts (cigar – shaped) in muscles.
· CT scan of the brain may show calcified spots, solid nodules ,cystic lesions containing a scolex or hydrocephalus.
· CT is more sensitive than MRI in identifying cystic lesions and enhancement .
· Specific enzyme-linked immunoelectrodiffusion transfer blot (EITB) using lentil-lectin purified glycoproteins is highly sensitive and specific.
· Histological examination of the excised subcutaneous nodule can establish a specific diagnosis.
Treatment
· For removal of the adult worm in the intestine , niclosamide (2 g as a single dose), praziquantel (5mg/kg ) or albendazole may be used.
· Neurocysticercosis should be treated on the following lines:
1. Albendazole 15mg /kg/ day for 2 – 4 weeks is the drug of choice.
2. An alternative anti-parasitic drug, praziquantel (PZQ) , can be used orally in a single-day regimen of three doses of 25 mg/kg/day given at 2 hour intervals , or low cyst burdens , but it is les efficadious in those with heavier cyst burdens.
3. Prednisolone 10 mg 8 hourly is given for 14 days , starting 1 day before the albendazole or praziquantel.
4. Antiepileptic drugs should be given until the reaction in the brain has subsided.
5. Operative intervention may be required for internal hydrocephalus.
Recent Comments