Cerebral Coenurosis of a Long-Tailed Goral, Naemorhedus caudatus, in Korea.

We intended to describe a case of cerebral coenurosis in a long-tailed goral, Naemorhedus caudatus, from Hwacheon-gun, Gangwon-do (Province), in the Korea. The goral, a 10-year-old male, was suffering from neurological symptoms, such as turning the circle to one side without lifting the head straight, and died at 30 days after admission to the wildlife medical rescue center in Chuncheon-si, Gangwon-do. A fluid-filled cyst was detected in the left cerebral hemisphere by computed tomography and magnetic resonance imaging. The cyst removed from the deceased goral was transparent, about 3×3 cm in size, contained a clear fluid and approximately 320 protoscolices invaginating from the internal germinal layer. The protoscolex had 4 suckers and a rostellum with 28 hooklets arranged in 2 rows. By the present study, a case of cerebral coenurosis was first confirmed in a long-tailed goral, N. caudatus, from Gangwon-do, in Korea. The residents frequently exposed in the sylvatic environment should be careful the accidental infections of zoonotic metacestode of Taenia multiceps, Coenurus cerebralis, in Korea.

Population Screening for Urine Antigens to Detect Asymptomatic Subarachnoid Neurocysticercosis: A Pilot Study in Northern Peru.

Subarachnoid neurocysticercosis (SANCC) is a severe and progressive brain infection with Taenia solium. We performed a pilot study of noninvasive screening for SANCC in two endemic villages in northern Peru using a urine antigen screen followed by brain magnetic resonance imaging for participants with elevated levels of antigen. Among the 978 participants screened, we identified eight individuals with SANCC, many of whom were asymptomatic. This represents a minimum prevalence of 0.8% of SANCC, a level higher than expected based on prior studies, and a positive predictive value of 62% for our novel urine screening test. Future studies should confirm whether early detection and management improve clinical outcomes.

Relationships among neuroscore, magnetic resonance imaging features, and intracranial pressure in sheep affected by slow-growing brain lesions.

Diagnosing high intracranial pressure by clinical and diagnostic imaging is particularly challenging for chronic or slow-growing lesions. The aim of this prospective case-control study is to determine whether the neuroscore and brain magnetic resonance imaging (MRI) are related to the direct measurement of intracranial pressure in sheep affected by intracranial slow-growing lesions due to chronic cerebral coenurosis (Coenurus cerebralis). Seventeen affected and 10 control sheep were included. All animals underwent a neurological examination, MRI of the brain, and direct measurement of intracranial pressure. The severity of clinical signs and MRI findings were scored. Data were statistically analyzed. The invasive intracranial pressure value was higher in affected animals. A severely altered neuroscore is related to an increased intracranial pressure beyond the normal threshold (P < 0.05). The volume of the calvarium was larger in affected animals than in control animals (P = 0.0001) and was positively influenced by the presence and volume of the parasitic cyst (r = 0.7881, P < 0.01). Several degrees of deviation and deformation of both the ventricular system and brain parenchyma were detected by MRI. Subjective MRI findings were not associated with intracranial hypertension. In conclusion, this study shows that in sheep affected by slow-growing lesions, severe alterations in the neuroscore and the results of objective MRI are related to an increased intracranial pressure beyond the normal threshold.

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large-scale, computed tomography-based population study in rural Ecuador.

OBJECTIVE: Using a large-scale population-based study, we aimed to assess prevalence and patterns of presentation of neurocysticercosis (NCC) and its relationship with epilepsy in community-dwellers aged ≥20 years living in Atahualpa (rural Ecuador). METHODS: In a three-phase epidemiological study, individuals with suspected seizures were identified during a door-to-door survey and an interview (phase I). Then, neurologists evaluated suspected cases and randomly selected negative persons to estimate epilepsy prevalence (phase II). In phase III, all participants were offered noncontrast computed tomography (CT) for identifying NCC cases. The independent association between NCC (exposure) and epilepsy (outcome) was assessed by the use of multivariate logistic regression models adjusted for age, sex, level of education, and alcohol intake. CT findings were subsequently compared to archived brain magnetic resonance imaging in a sizable subgroup of participants. RESULTS: Of 1,604 villagers aged ≥20 years, 1,462 (91%) were enrolled. Forty-one persons with epilepsy (PWE) were identified, for a crude prevalence of epilepsy of 28 per 1,000 population (95% confidence interval [CI] = 20.7-38.2). A head CT was performed in 1,228 (84%) of 1,462 participants, including 39 of 41 PWE. CT showed lesions consistent with calcified parenchymal brain cysticerci in 118 (9.6%) cases (95% CI = 8.1-11.4%). No patient had other forms of NCC. Nine of 39 PWE, as opposed to 109 of 1,189 participants without epilepsy, had NCC (23.1% vs. 9.2%, p = 0.004). This difference persisted in the adjusted logistic regression model (odds ratio = 3.04, 95% CI = 1.35-6.81, p = 0.007). SIGNIFICANCE: This large CT-based study demonstrates that PWE had three times the odds of having NCC than those without epilepsy, providing robust epidemiological evidence favoring the relationship between NCC and epilepsy.

Long-term Taenia saginata infection successfully treated with meglumine/diatrizoate sodium.

A 46-year-old Japanese man visited our hospital for chronic abdominal pain, persistent diarrhea and discharge of proglottids for 7 years. He had been living in Lao People's Democratic Republic. Ileography using meglumine/diatrizoate sodium (Gastrografin) revealed a long tapeworm. A Taenia saginata including the scolex was excreted through the intestinal tract by the administration of total 780 ml of Gastrografin. Taeniasis is an important disease in the differential diagnosis of imported diseases in Japan. Parasite infection should be suspected in patients with chronic abdominal pain or persistent diarrhea regardless of the findings for small bowel obstruction when there is a history of overseas travel.

Intestinal obstruction caused by Taenia taeniaeformis infection in a cat.

An adult domestic shorthair (DSH) cat was presented with acute vomiting, anorexia, lethargy, and dyspnea. The cat's clinical status worsened over 24 hours with conservative medical management. An exploratory celiotomy was performed. Acute intestinal obstruction resulting from infection with Taenia (T.) taeniaeformis was diagnosed. Surgical removal of the cestodes via multiple enterotomies resolved the obstruction. This paper reports, for the first time, small intestinal obstruction caused by T. taeniaeformis infection in a cat.

Huge hemispheric intraparenchymal cyst caused by Taenia multiceps in a child. Case report.

The authors report an unusual case of a huge intraparenchymal cyst in a 4-year-old girl caused by Taenia multiceps infection. After surgical removal of the cyst, the child recovered completely. Brain infestation by coenurus is a rare disease, mainly reported in Africa, with a few case reports from patients in developed countries. Humans, especially young children, become intermediate hosts by ingesting eggs passed in the excrement of a definitive host, usually carnivores. In such cases, high mortality and morbidity rates have been reported. These rates decreased after the introduction of the modem neuroradiological techniques of computed tomography and magnetic resonance imaging.

Taenia coenurus in the orbit of a chinchilla.

A 4-year old, male intact, captive-bred chinchilla (Chinchilla lanigera) was presented due to progressive exophthalmos of the right eye over a 5-month period. Ophthalmic examination revealed exophthalmos with dorsal displacement of the right globe. Retropulsion was decreased and a fluctuant, subcutaneous mass could be palpated posterior and dorsal to the central aspect of the zygomatic bone. Transdermal ultrasonography revealed a fluid-filled mass consistent with a cyst located within the ventral right orbit. Computed tomography demonstrated dorsal displacement of the globe, lateral displacement of the zygomatic arch, and numerous mineral-dense foci within the lumen of the cyst. The cyst was removed en bloc by ventral transpalpebral orbitotomy. Histopathology revealed a single capsulated cyst with multiple invaginated protoscolices, characterized by a prominent scolex with refractile hooklets, suckers, and abundant calcareous corpuscles consistent with a Taenia coenurus. Exophthalmos resolved with surgical therapy and there was no evidence of recurrence or postoperative complications over a period of 2 years. To the authors' knowledge, this is the first reported case of an orbital cyst of parasitic origin in a chinchilla.

Ultrasonographic appearance of colon taeniasis.

We present the case of a 50-year-old woman with abdominal pain, nausea, loss of appetite, and frequent stools in whom the routine ultrasonographic examination demonstrated a double-reflective, ribbon-like structure in the lumen of the initial segment of the ascending colon, which suggested colon taeniasis. Because the initial parasitologic analysis yielded negative results and application of albendazol did not have any therapeutic effect, the diagnosis was confirmed by barium enema and subsequently by parasitologic examination of proglottids passed in the stool after application of niclosamide. The double-reflective, ribbon-like structure in the lumen of the intestine seems to be specific to the ultrasonographic appearance of intestinal taeniasis. Transcutaneous ultrasonography of the gastrointestinal tract, performed as a screening method before conventional radiologic or endoscopic examination, can point to the ultimate diagnosis of colon taeniasis.

Colonic perforation caused by taeniasis.

In this report, a case of colonic perforation caused by Taenia saginata is presented. Preoperative ultrasonographic examination showed a 'pseudokidney sign' suggestive of colonic carcinoma. Clinical and ultrasonographic appearance of this rare case and the possible perforation mechanism are discussed.

Successful treatment of Diphyllobothrium latum and Taenia saginata infection by intraduodenal 'Gastrografin' injection.

Tapeworm infections are very difficult to cure completely. Thirteen patients with tapeworm infection, seven with Diphyllobothrium latum and six with Taenia saginata, were treated by the introduction of a radio-opaque contrast medium, 'Gastrografin', into the duodenum through a duodenal tube. The whole tapeworm with the scolex was expelled unfragmented within 1 h in eleven cases. One patient expelled a tapeworm 3 days after treatment; the peristalsis of his intestine had been severely disturbed after an attack of cerebral apoplexy. The tapeworm could not be expelled by the remaining patient, probably because she had severe intestinal adhesion. The injection of gastrografin allowed clear visualisation of the tapeworm, the diagnosis of the infection could be confirmed, and the descent of the tapeworm could be observed serially. This treatment had no serious adverse effects in any of out patients.