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Cysticercosis

Definition

Cysticercosis is an infection by a parasite called Taenia solium (T. solium), a pork tapeworm that creates cysts in different areas in the body.

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Causes, incidence, and risk factors

Cysticercosis is caused by swallowing eggs from T. solium, which are found in contaminated food. Autoinfection is when a person is already infected with adult T. solium, then swallows eggs following improper hand washing after a bowel movement.

Risk factors include eating pork, fruits, and vegetables contaminated with T. solium as a result of unhealthy cooking or food preparation. The disease can also be spread by contact with infected feces.

The disease is rare in the United States, but is common in many developing countries.

Symptoms

Most often, the worms stay in muscles and do not cause symptoms.

Symptoms that do occur depend on where the infection is found in the body:

Brain -- seizures or symptoms similar to those of a brain tumor
Eyes -- decreased vision or blindness
Heart -- abnormal heart rhythms or heart failure (rare)
Spine -- weakness or changes in walking due to damage to nerves in the spine

Signs and tests

Tests that may be done include:

Blood tests to detect antibodies to the parasite
Biopsy of the affected area
CT scan, MRI scan, or x-rays to detect the lesion
Spinal tap (lumbar puncture)
Test in which an ophthalmologist looks inside the fundus of the eye

Treatment

Treatment may involve:

Medications to kill the parasites (antiparasitic treatments such as albendazole or praziquantel)
Powerful anti-inflammatories (steroids) to reduce swelling

If the cyst is in the eye or brain, steroids should be started a few days before other medicines to avoid problems caused by swelling during antiparasitic treatment. Not all patients benefit from antiparasitic treatment.

Sometimes surgery may be needed to remove the infected area.

Expectations (prognosis)

The outlook is generally good, unless the lesion has caused blindness, heart failure, or brain damage. These are rare complications.

Complications

Blindness, decreased vision
Heart failure or abnormal heart rhythm
Hydrocephalus (fluid build-up in part of the brain, often with increased pressure)
Seizures

Calling your health care provider

If you have any symptoms of cysticercosis, contact your health care provider.

Prevention

Avoid unclean foods, don't eat uncooked foods while traveling, and always wash fruits and vegetables well.

References

White AC Jr., Brunetti E. Cysticercosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th. Philadelphia, Pa: Saunders Elsevier; 2011:chap 362.

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