Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Objetivo: Las comunicaciones bucosinusales y buco- nasales son condiciones patológicas que se caracterizan por la presencia de una solución de continuidad entre la cavidad bucal y el seno maxilar o la cavidad nasal respectivamente. Una vez que se ha instalado una comunicación es deseable ce- rrar este defecto, evitando así la infección del seno maxilar y posibles dificultades en la deglución, fonación y masticación. Se han propuesto diferentes tratamientos para su resolución, algunos no quirúrgicos y otros quirúrgicos. Los quirúrgicos pueden realizarse desplazando tejidos locales, regionales o injertando. El presente trabajo tiene como objetivo presentar situaciones clínicas de comunicaciones bucosinusales y buco- nasales con diferentes etiologías y sus distintos tratamientos según tamaño y ubicación del defecto. Casos clínicos: Se identificaron pacientes que asistie- ron al Servicio de Cirugía Maxilofacial del Hospital Piñero presentando cuatro comunicaciones bucosinusales agudas y crónicas y una comunicación buconasal crónica. Los casos analizados fueron tratados de manera quirúrgica utilizando di- versos colgajos según tamaño y ubicación del defecto (AU)

Aim: Oroantral and oronasal communications are patho- logical conditions characterized by the presence of a solu- tion of continuity between the oral cavity and the maxillary sinus or nasal cavity respectively. Once a communication has been installed, it is desirable to close this defect, thus avoid- ing infection of the maxillary sinus and possible difficulties in swallowing, phonation, and mastication. Different treatments have been proposed for its resolution, some non-surgical and others surgical. Surgical procedures can be performed by dis- placing local or regional tissue or by grafting. The aim of this case report is to present clinical situations of oral sinus and oral nasal communication with different etiologies and their different treatments according to the size and location of the defect. Clinical cases: A group of patients who attended the Maxillofacial Surgery Service of Piñero Hospital presenting four acute and chronic oral sinus and one oronasal communi- cations were identified. The analyzed cases were treated sur- gically using different flaps according to the size and location of the defect (AU)

Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Resumen Objetivo La cisticercosis es una infección causada por el estado larvario de la tenia del cerdo, Taenia solium. La cavidad bucal es un sitio raro para su localización y representa un desafío diagnóstico para los odontólogos. Se presenta un caso clínico poco frecuente de una cisticercosis lingual en un paciente adulto y su resolución. Caso clínico Paciente de sexo femenino de 23 años de edad, que se presenta ambulatoriamente por una lesión tumoral localizada en el borde lingual del lado derecho, indolora, de crecimiento lento y evolución crónica. Si bien este tipo de tumor es infrecuente, es importante tener conocimiento de su existencia para su correcto diagnóstico clínico, diferencial y su tratamiento.

Abstract Aim Cysticercosis is an infection caused by the larval state of the pig's tapeworm, Taenia solium. The oral cavity is a rare place for its location and represents a diagnostic challenge for dentists. This article presents a rare clinical case of a lingual cysticercosis in an adult patient and its resolution. Clinical case: A 23 -year-old female patient presents as an outpatient due to a tumor lesion located on the right side of the lingual edge, painless, slow-growing and chronic evolution. Although this type of tumor is uncommon, it is important to have knowledge of its existence for its correct clinical, differential diagnosis and treatment.

Vigilancia serológica de la zoonosis parasitaria en 13 regiones de la sierra del Perú: Periodo 2016-2019 / Serological surveillance of parasitic zoonoses in 13 highlands regions of Peru: Period 2016-2019

RESUMEN Objetivos. Determinar la seropositividad a anticuerpos anti-IgG por infección de Echinococcus granulosus, Fasciola hepatica y cisticerco de Taenia solium y describir las características de los infectados en 13 regiones de la sierra peruana entre 2016 y 2019. Materiales y métodos. Estudio observacional transversal, que analizó 7811 fichas epidemiológicas de la vigilancia basada en laboratorio de las zoonosis parasitarias del periodo 2016-2019. El diagnóstico se realizó mediante la detección de anticuerpos tipo IgG anti E. granulosus, F. hepatica y cisticerco de T. solium utilizando antígenos nativos mediante el ensayo inmunoabsorbente ligado a enzimas (ELISA) e Inmunoblot. La diferencia en la frecuencia de casos de estas zoonosis según características identificadas se realizó mediante la prueba chi-cuadrado de Pearson y prueba exacta de Fisher. Resultados. Se determinó una seropositividad de 7,9% para fascioliasis, 4,9% para equinococosis quística, y 2,3% para cisticerco de T. solium. Estas frecuencias fueron mayores en Cerro de Pasco para equinococosis quística (24,5%), en Ayacucho para cisticerco de T. solium (4,5%) y en Puno para fascioliasis (40,6%). Entre las características sociodemográficas, se encontró una diferencia estadísticamente significativa en la frecuencia de casos para todas las zoonosis según grupo etario, ocupación, y región de residencia. Además, se encontró diferencia con el consumo de verduras en emolientes, y entre las características clínico-epidemiológicas con tener antecedentes familiares de las zoonosis parasitarias. Conclusiones. A partir de las 7811 muestras evaluadas, se encontró que estas zoonosis parasitarias están distribuidas en 13 regiones de la sierra del Perú, ocasionando un problema de salud importante, con frecuencias que varían según diversas características.

ABSTRACT Objectives. To determine seropositivity to anti-IgG antibodies against Echinococcus granulosus, Fasciola hepatica and Taenia solium cysticercus infection and to describe the characteristics of the infected patients in 13 regions of the Peruvian highlands between 2016 and 2019. Materials and methods. Cross-sectional, observational study, in which we analyzed 7811 epidemiological records of laboratory-based surveillance of parasitic zoonoses from 2016 to 2019. Diagnosis was established by detecting IgG type anti-E. granulosus, F. hepatica and T. solium cysticercus antibodies using native antigens by enzyme-linked immunosorbent assay (ELISA) and Immunoblot. We evaluated the difference in the frequency of the cases according to identified characteristics using Pearson's chi-square test and Fisher's exact test. Results. Seropositivity was 7.9% for fascioliasis, 4.9% for cystic echinococcosis, and 2.3% for T. solium cysticercus. These rates were higher in Cerro de Pasco for cystic echinococcosis (24.5%), in Ayacucho for T. solium cysticercus (4.5%) and in Puno for fascioliasis (40.6%). Regarding the sociodemographic characteristics, we found a statistically significant difference in the frequency of cases for all zoonoses according to age group, occupation, and region of residence. We also found a difference with the consumption of vegetables in emollients, and between clinical-epidemiological characteristics and having a family history of parasitic zoonoses. Conclusions. From the 7811 samples, we found that these parasitic zoonoses are distributed in 13 regions of the Peruvian highlands, and represent a major health problem, with frequencies that change according to different characteristics.

Prevalence of Taenia solium taenaisis in Kanchipuram district of Tamil Nadu (India): A cross-sectional study

Background: Taenia solium infections in humans include the infection by the adult tapeworm, these infections are of public health concern and are among the most important afflictions of humans who live in areas of poverty in the developing world and least developed countries. T. solium, a zoonotic disease, transmitted between pigs and humans and among humans, is common in developing countries. Aims and Objectives: The aim of the study was to estimate the detection rate of T. solium taeniasis among patients and random community screening with an indication of intestinal parasitic infection by routine stool examination. Materials and Methods: Stool samples were collected from the community and patients. Those who were willing, samples were screened for the cysts/ova/egg by direct microscopic examination by saline, iodine, concentration technique, and modified acid fast staining, were performed to differentiate species of T. solium and Taenia saginata. Results: Overall samples were 2030, out of which 870 stool samples were from community field screening 585 (28.81%) were positive. 1160 from tertiary care center, 668 (32.90%) were positive gave a total prevalence of intestinal parasitic infection of 61.72%. The prevalence of T. solium taeniasis was 194 (9.55%) out of which 92 (4.53%) were from community and 102 (5.02%) were from tertiary care center. Conclusion: The high prevalence of intestinal parasitic infestation might be due to the poor sanitary, contaminated water, and lack of education that is prevalent in the studied region as in other pockets in rural India. Our study showed the usefulness of the Ziehl-Neelsen modified acid-fast stain for identification of Taenia species.

Neurocisticercosis y epilepsia en un hospital universitario de Popayán, Colombia: una serie de casos / Neurocysticercosis and epilepsy in a university hospital in Popayán, Colombia: A case series

RESUMEN INTRODUCCIÓN: La neurocisticercosis es una infección del sistema nervioso central causada por el estadio larvario del cestodo Taenia solium, y se estima que puede ocasionar hasta 30% de los casos de epilepsia en los países donde esta parasitosis es endémica. El objetivo de este estudio fue determinar la frecuencia de pacientes que presentaron epilepsia como secuela de neurocisticercosis en un hospital universitario en Popayán. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo con todos los pacientes con diagnóstico de neurocisticercosis que ingresaron al Hospital Universitario San José entre enero 2014 y diciembre 2018 que cumplieron los criterios de inclusión. RESULTADOS: Se encontraron 50 pacientes, de estos, 40 (80%) reingresaron, encontrándose que 37 (74%) presentaron epilepsia como secuela. Las edades más afectadas fueron la de 41 a 60 años; 48 (96%) provenían del departamento del Cauca en especial de Mercaderes, y 33 (66%) de área rural. El síndrome convulsivo fue la manifestación clínica de ingreso más frecuente. La TAC fue la técnica de imagen de elección. CONCLUSIÓN: El departamento del Cauca se considera como una de las áreas endémicas para neurocisticercosis en Colombia, y la epilepsia secundaria es un secuela común.

ABSTRACT INTRODUCTION: Neurocysticercosis is an infection of the central nervous system caused by the larval stage of the cestode Taenia solium, it has been estimated to produce up to 30% of the cases in countries where this parasitosis is endemic. The objective of this study was to determine the frequency of patients who presented epilepsy as a sequel of neurocysticercosis in a university hospital in Popayán. MATERIALS AND METHODS: A retrospective study was conducted with all patients with a diagnosis of neurocysticercosis who were admitted to the Hospital Universitario San José between January 2014 and December 2018 who met the inclusion criteria. RESULTS: We found 50 patients, 40 (80%) of which were readmitted and 37 (74%) presented epilepsy as sequela. The most affected age-group was 41 to 60 years; 48 (96%) were from the department of Cauca, especially Mercaderes, and 33 (66%) from rural areas. Convulsive syndrome was the most frequent clinical manifestation on admission. CT was the imaging technique of choice. CONCLUSION: The department of Cauca is considered as an endemic area for neurocysticercosis, and secondary epilepsy was a common consequence.

A case with severe neurocysticercosis / 中国血吸虫病防治杂志

This case report described the diagnosis and treatment of an ethnic Tibetan case with severe neurocysticercosis residing in agricultural areas of Sichuan province.

Ocular cysticercosis in pediatric patient / Cisticercose ocular em paciente pediátrico

ABSTRACT Ocular cysticercosis is a parasitic infection caused by Taenia solium. Its early diagnosis and treatment decreases the possibility of visual morbidity. It can either compromise the anterior chamber or the posterior segment, which translates into an very variable and interspecific presentation that changes depending on the site of the infection. It is important to report this case due to its low presentation rate and the fact that a high suspicion index is required to make an assertive and timely diagnosis. This is especially important in geographical areas that are endemic to this parasite due to the direct relationship between an early diagnosis and treatment and better visual outcomes. In this case report, we will discuss the multidisciplinary interventions of a pediatric patient in a high complexity hospital.

RESUMO A cisticercose ocular é uma infecção parasitária causada pela Taenia solium. O diagnóstico e tratamento precoces diminuem a possibilidade de morbidade visual. Ela pode comprometer a câmara anterior ou o segmento posterior, o que se traduz em uma apresentação muito variável e interespecífica, que muda dependendo do local da infecção. É importante relatar esse caso devido à sua baixa taxa de apresentação e ao fato de que é necessário um alto índice de suspeita para fazer um diagnóstico assertivo e oportuno. Isso é especialmente importante em áreas geográficas endêmicas para esse parasita, devido à relação direta entre diagnóstico e tratamento precoces e melhores resultados visuais. Neste relato de caso, discutiremos as intervenções multidisciplinares de um paciente pediátrico em um hospital de alta complexidade.

Apuntes actualizados sobre la neurocisticercosis

Introducción: La neurocisticercosis es una infección parasitaria prevenible, producida por los quistes larvarios de la Taenia solium (solitaria), que pueden infectar cualquier parte del cuerpo, en este caso, el cerebro, siendo la forma más grave de la enfermedad y en ocasiones puede ocasionar convulsiones e incluso llegar a ser mortal. Objetivo: Sistematizar la información acerca de esta patología. Método: Se realizó una búsqueda bibliográfica actualizada en bases de datos como PubMed, Google Scholar, Medline, Web of Science, Cochrane Library y ClinicalKey, así como en revistas de alto impacto en SciELO, Scopus, complementada la información con revisiones sistemáticas, estudios clínicos aleatorizados y enfoques de metaanálisis, en los cuales se indagaron palabras claves para facilitar la búsqueda como: "Neurocisticercosis", "Fisiopatología", "etiología", "manifestaciones clínicas", "prevalencia", "morbimortalidad", "diagnostico", "tratamiento". Desarrollo: La investigación permitió reconocer el arduo trabajo que se precisa en el diagnóstico de esta enfermedad, debido a la dificultad que requiere su tipificación Se destacó la importancia de los estudios de neuroimagen como herramientas para calificar la gravedad de la neurocisticercosis y, de esta manera, escoger el tratamiento adecuado. Se desarrollaron acápites de: epidemiología, etiopatogenia, ciclo de vida, manifestaciones clínicas, clasificación, estadio evolutivo de las lesiones, diagnóstico, criterios diagnósticos, y tratamiento. Conclusiones: Ecuador es considerado como un país endémico para la Taenia solium. Implementar la prevención debe ser un pilar fundamental del ministerio de salud debido a la persistencia de los factores de riesgo para la infección de este parásito y el conjunto de aspectos asociados a la precaria calidad de vida en muchos sitios del país.

Introduction: Neurocysticercosis is a preventable parasitic infection caused by larval cysts of Taenia solium (tapeworm), which can infect any part of the body, including the brain and is the most severe form of the disease, sometimes lead to seizures and even be fatal. Objective: To synthesize information concerning this pathology. Method: An updated bibliographic search was carried out in databases such as PubMed, Google Scholar, Medline, Web of Science, Cochrane Library and ClinicalKey, as well as in high impact journals like SciELO, and Scopus. The information gathered was complemented with the use of systematic reviews, randomized clinical studies and meta-analysis approaches, in which to facilitate the search process various key words were used: "neurocysticercosis", "pathophysiology", "etiology", "clinical manifestations", "prevalence", "morbimortality", "diagnosis", and "treatment". Development: The research allowed the researchers to recognize the arduous work required for the diagnosis of this disease, assuming as well how difficult is to typify it. The importance of neuroimaging studies as tools to qualify the severity of neurocysticercosis and, thus, to choose the appropriate treatment was highlighted. The following sections were developed: epidemiology, etiopathogenesis, life cycle, clinical manifestations, classification, and evolution of lesions, diagnosis, diagnostic criteria, and treatment. Conclusions: Ecuador is considered an endemic country for Taeniasolium. The implementation of preventive actions should be regarded as a fundamental task of the Ministry of Health due to the permanent surrounding risk factors, which have an influence for getting infection and the set of aspects associated with the precarious quality of life in many parts of the country.

Introdução: A neurocisticercose é uma infecção parasitária evitável, produzida pelos cistos larvais da Taenia solium (tênia solium), que pode infectar qualquer parte do corpo, neste caso, o cérebro, sendo a forma mais grave da doença, podendo por vezes causar convulsões e podem até ser fatais. Objetivo: Sistematizar as informações sobre esta patologia. Método: Foi realizada busca bibliográfica atualizada em bases de dados como PubMed, Google Scholar, Medline, Web of Science, Cochrane Library e ClinicalKey, bem como em revistas de alto impacto no SciELO, Scopus, complementando as informações com revisões sistemáticas, análises clínicas estudos randomizados e abordagens de meta-análise, em que foram investigadas palavras-chave para facilitar a busca como: "Neurocisticercose", "Fisiopatologia", "etiologia", "manifestações clínicas", "prevalência", "morbidade e mortalidade", "diagnóstico" , "tratamento". Desenvolvimento: A pesquisa permitiu reconhecer o árduo trabalho que é exigido no diagnóstico desta doença, pela dificuldade que a sua tipificação exige, destacou-se a importância dos estudos de neuroimagem como ferramentas para qualificar a gravidade da neurocisticercose e, neste maneira, escolher o tratamento adequado. Foram desenvolvidas seções sobre: epidemiologia, etiopatogenia, ciclo de vida, manifestações clínicas, classificação, estágio evolutivo das lesões, diagnóstico, critérios diagnósticos e tratamento. Conclusões: O Equador é considerado um país endêmico para Taenia solium. A implementação da prevenção deve ser um pilar fundamental do Ministério da Saúde devido à persistência de fatores de risco para infecção por este parasita e ao conjunto de aspectos associados à precária qualidade de vida em muitas partes do país.

PREVALENCE OF NEUROCYSTICERCOSIS IN AND AROUND OF RURAL KANCHIPURAM.

Cysticercosis has been reported as the most common illness affecting the central nervous system by cystic stage of Taenia. solium pork tapeworm. It is also referred as food borne zoonotic infection with T.solium larva or cysticercus stage in humans. Cysticercosis which affects central nervous system is called neurocysticercosis (NCC). The clinical manifestation of NCC largely depends on the number, type, size of the cysts, stage of development of cyst and degree of host immune response against the parasite. The present study aimed to assess the burden of Objectives: neurocysticercosis infection by CT imaging and antigen detection by ELISA in the community as well as hospital based patients. Blood samples were collected and antigen detection of cysticercosis by ELISA were done and CT Brain was Methods: done to con?rm the diagnosis of neurocysticercosis among the participants. The overall clinical presentation among Results: 640 subjects showed seizure as the major presentation 446 (69.69%). The overall results of the commercial-Ag-ELISA revealed 61 of 446 sera to be positive for Cysticercus antigen, and thus con?rming 13.68% total prevalence of neurocysticercosis in the study region. High index of exposure to T. solium cysticercosis in the study region of south Indian. An early Conclusion: diagnosis and appropriate treatment management can improve the quality of life of a patient.

Infección experimental cerebral con cisticercosis en ovejas / Experimental brain infection with cysticercosis in sheep

RESUMEN Objetivo . Explorar la viabilidad de desarrollar un modelo de neurocisticercosis (NCC) de oveja mediante infección intracraneal de oncosferas de T. solium. Materiales y métodos. Se realizó un modelo de infección experimental de NCC en ovejas. Se inocularon aproximadamente 10 posoncósferas de T. solium cultivadas previamente por 30 días por vía intracraneal en diez ovejas. Las oncósferas, en 0,1 mL de solución salina fisiológica, se inyectaron en el lóbulo parietal a través de una aguja de calibre 18. Resultados. Después de tres meses, en dos ovejas se encontraron granulomas y en una tercera identificó un quiste de 5 mm de diámetro en el ventrículo lateral derecho y la evaluación histológica confirmó que el quiste corresponde a una larva de T. solium. También se utilizó inmunohistoquímica con anticuerpos monoclonales dirigidos contra componentes de membrana y antígenos excretorios/secretorios del quiste de T. solium para confirmar la etiología de los granulomas encontrados. Uno de ellos mostro reactividad ante los anticuerpos monoclonales utilizados, confirmando así que se trató de un cisticerco. Conclusión. Este experimento es la prueba de concepto de que es posible infectar ovejas con cisticercosis por inoculación intracraneal.

ABSTRACT Objective. To explore the feasibility of developing a sheep model of neurocysticercosis (NCC) by intracranial infection with T. solium oncospheres. Materials and methods. We carried out an experimental infection model of NCC in sheep. Approximately 10 T. solium oncospheres previously cultured for 30 days were inoculated intracranially into ten sheep. The oncospheres, in 0.1 mL of physiological saline, were injected into the parietal lobe through an 18-gauge needle. Results. After three months, granulomas were found in two sheep. In a third sheep we identified a 5 mm diameter cyst in the right lateral ventricle and histological evaluation confirmed that the cyst corresponded to a T. solium larva. Immunohistochemistry with monoclonal antibodies directed against membrane components and excretory/secretory antigens of the T. solium cyst was also used to confirm the etiology of the found granulomas. One of them showed reactivity to the monoclonal antibodies used, thus confirming that it was a cysticercus. Conclusion. This experiment is the proof of concept that it is possible to infect sheep with cysticercosis by intracranial inoculation.

Asymptomatic isolated intramuscular cysticercosis in diabetic patient: a case report

Cysticercosis is an endemic disease in multiple areas of the world, caused by ingestion of embryonated eggs of Taenia solium. We reported a case of a 66-year old diabetic male presenting with decrease of consciousness and “rice grain” calcification in bothhemithorax and neck soft tissue region, without findings of cysticercosis in computed tomography (CT) scan. Cysticercosis most commonly affects the central nervous system, causing neurocysticercosis(NCC), while solitary intramuscular cysticercosis without involvement of the central nervous system is rare. Treatment of cysticercosis is indicated for symptomatic patients, including NCCsurgery is indicated in patients with neurovascular compromise caused by growth of cyst. Recognizing the signs and symptomsof cysticercosis is crucial for diagnosis and treatment in endemic areas where Taenia soliumis prevalent.

Update on the diagnosis and management of neurocysticercosis / Atualização no diagnóstico e manejo da neurocisticercose

ABSTRACT Background: Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be the main cause of late-onset epilepsy in endemic areas. Objective: This review summarizes recent advances in diagnosis and therapy of NCC. Methods: Relevant articles and books were reviewed and used as a source of information for this review. Results: The diagnosis of NCC is based upon neuroimaging studies (MRI and computed tomography) and laboratory analysis of the cerebrospinal fluid (CSF). Praziquantel and albendazole are considered parasiticidal drugs against NCC, but there is an intense debate over the value and safety of these drugs. Conclusion: Given the relative scarcity of clinical trials, more comparative interventional studies, especially randomized controlled trials in long-term clinical evolution, are required in order to clarify the controversy over the validity of parasitic therapy in patients with NCC.

RESUMO Antecedentes: A neurocisticercose (NCC) é grave problema de saúde pública nos países em desenvolvimento, especialmente na América Latina, Ásia e África. A NCC é considerada a principal causa de epilepsia de início tardio nas regiões endêmicas. Objetivo: Este artigo pretende discutir os recentes avanços no diagnóstico e tratamento da NCC. Métodos: Artigos científicos e livros relevantes serviram de fonte de informação para esta revisão. Resultados: O diagnóstico da NCC é fundamentado nos exames de neuroimagem (ressonância magnética e tomografia computadorizada) e do líquido cefalorraquiano (LCR). Atualmente, praziquantel e albendazole são considerados eficazes na terapêutica etiológica da NCC, mas há intenso debate quanto à validade e segurança desses medicamentos. Conclusão: Pela relativa carência de ensaios clínicos, são necessários novos estudos particularmente randomizados, controlados e com análise de desfechos clínicos a longo prazo para o esclarecimento da polêmica envolvendo a validade da terapêutica parasiticida na NCC.

A Rare Case of Peripheral Cysticercosis in a Young Female from South India

Human Cysticercosis, a potentially deadly infestation, is the consequence of ingestion of eggs of Taenia solium. Cysticercosis is the most common parasitic infestation of the Central Nervous System, Muscle and Subcutaneous Tissue. About 54% of the patients present with subcutaneous nodules combined with nervous involvement. Cysticercosis is the most common Parasitic Disease of the Central Nervous System in the world but Cysticercosis cutis has been reported much less frequently(less than 2%). Here we are discussing a case of peripheral cysticercosis for which Surgery was done followed by medical treatment. Our patient came with a swelling on the left forearm near cubital fossa duration progressively increasing in size for the past 4 months. Complaints of pain over the swelling. MRI of the swelling was taken which showed a cystic swelling in the subcutaneous plane with a scolex in situ. After ruling out Neurocysticercosis, patient was taken up for excision of the cyst. Histopathology reported positive for cysticercosis with in situ scolex.Postoperative period uneventful and the patient was given a course of albendazole for two weeks. Majority of the patients will be presenting with Neurological Symptoms as Neurocysticercosis. Albendazole is considered as the treatment of choice in most of the cases and is cost effective. An alternate choice is praziquantel which might be given for some patients. Surgical management is preferred for peripheral cyst which is one of the rarest presentation.

Effectiveness of training on Taenia solium taeniasis and cysticercosis control knowledge among medical professionals in disease-elimination pilot areas of Henan Province / 中国血吸虫病防治杂志

Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County, a disease-elimination pilot area of Henan Province, so as to evaluate the effectiveness of the training. Methods Three townships in Fangcheng County were randomly selected as the study townships, including Dushu, Bowang and Yangji townships, while Erlangmiao, Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships. The grassroots medical professionals in the study townships were given once training on T. solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020, while those in the control townships were given no interventions. All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups. The baseline and final assessments of the awareness of T. solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020, and the awareness of T. solium taeniasis and cysticercosis control knowledge was compared between the two groups. Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020, including 474 participants in the intervention group and 189 participants in the control group. Results from the 2016 baseline survey showed that the awareness rate of T. solium taeniasis and cysticercosis control knowledge was 28.83% (47/163) among grassroots medical professionals in Fangcheng County, and there were no significant differences in the awareness between the intervention (32.47%, 25/77) and control groups (25.58%, 22/86) (χ2 = 0.939, P > 0.05), between men (30.50%, 43/141) and women (18.18%, 4/22) (χ2 = 1.406, P > 0.05) or between village- (31.39%, 43/137) and township-level medical professionals (15.38%, 4/26) (χ2 = 2.727, P > 0.05), while significant differences were found in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels (χ2 = 8.190, P < 0.05) and duration of working experiences (χ2 = 12.617, P < 0.05), and the awareness rate of T. solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals (χ2 = 6.768, P < 0.05). Only 5.52% (9/163) of the medical professionals had a history of diagnosis and therapy of T. solium taeniasis or cysticercosis, and only 1.23% (2/163) received training on T. solium taeniasis and cysticercosis control knowledge during the past 5 years. Results from the 2020 questionnaire survey showed a higher awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group (93.55%, 116/124) than in the control group (46.60%, 48/103) (χ2 = 61.845, P < 0.05), and no significant differences were seen in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender, level of medical professionals, duration of working experiences or history of diagnosis/therapy of T. solium taeniasis and cysticercosis in the intervention group (χ2 = 1.089, 0.140, 0.081 and 0.453, all P values > 0.05), while there was a significant difference in the awareness rate among medical professionals with different education levels (χ2 = 36.338, P < 0.05). In addition, the awareness rate of T. solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016. Conclusions In the low-prevalence areas of T. solium taeniasis and cysticercosis, long-term and persistent training may improve the awareness of T. solium taeniasis and cysticercosis control knowledge among grassroots medical professionals, which facilitates the timely identification of T. solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.

Prevalencia de cisticercosis en porcinos de la provincia de Tambopata, Perú / Cysticercosis Prevalence in Pigs in the Tambopata Province, Perú

Resumen La cisticercosis es una de las principales enfermedades zoonóticas parasitarias que es causada por el establecimiento de la forma larvaria de Taenia solium. Esta enfermedad se desarrolla principalmente en cerdos que son criados en granjas sin tecnificación, donde el uso de la tecnología y las condiciones sanitarias son mínimas. Este tipo de crianza es muy usual, por lo que representa un riesgo de la salud pública. En ese sentido, se determinó la prevalencia de cisticercosis en porcinos de la provincia de Tambopata, donde fue evaluado un total de 98 porcinos. Se tomaron aproximadamente 5 ml de sangre de la vena cava en animales mayores de 6 meses y hembras que no estuviesen preñadas; posteriormente, se obtuvo el plasma para ser procesado mediante la prueba de enzyme-linked inmunoelectrotransfer bloot assay (EITB) o Western Blot. Se determinó que el 17 % de los cerdos evaluados dio positivo para cisticercosis; con respecto al sexo, se obtuvo una seroprevalencia de 5,21 % ± 0,82 % para machos y 11,45 % ± 1,93 % para hembras. Finalmente, se determinó una seroprevalencia de 10,41 % ± 1,75 % para animales jóvenes de 6 a 11 meses y 6,25 % ± 1,01 % para animales adultos de 12 meses a más. Estos resultados reflejan la importancia de la vigilancia y control de las enfermedades parasitarias en los animales de producción ya que pudo corroborarse que la cisticercosis porcina constituye un serio problema de salud pública.

Abstract Cysticercosis is one of the main zoonotic parasitic diseases caused by the larval settlement of Taenia solium. This disease develops mainly in pigs that are reared in non-technified farms where the use of technology and the sanitary conditions are poor. It is quite usual to rear pigs this way and, therefore, there is a public health risk. In this sense, the cysticercosis prevalence was determined among pigs in the Tambopata Province, including 98 animals in the evaluation. Approximately 5 ml of blood were taken from the vena cava in more than 6-month-old female pigs that were not pregnant. Next, the plasma was taken in order to be processed under an enzyme-linked inmunoelectrotransfer bloot assay (EITB) or western blot. It was found that 17% of pigs were positive to cysticercosis. Regarding the sex, the seroprevalence was 5.21% ± 0.82% in males and 11.45% ± 1.93% in females. Finally, the seroprevalence was determined at 10.41% ± 1.75% in young animals (6 to 11 months old) and 6.25% ± 1.01% in adult animals (12 months old and above). These results show how important it is to monitor and control the parasitic diseases in production animals as this study confirmed that porcine cysticercosis is a serious problem in public health.

Eficacia de dos formulaciones de oxfendazol producidas localmente para el tratamiento de la cisticercosis en cerdos infectados naturalmente

Se evaluó la eficacia de dos formulaciones de oxfendazol (OFZ) contra cisticercosis producidas localmente, al 22,5% y 10% en comparación con una formulación comercial (Synanthic 9,06%) en 22 cerdos naturalmente infectados, que recibieron una dosis oral de 30 mg/kg. Los cerdos fueron sacrificados a las ocho semanas postratamiento para evaluar quistes en en sus carcasas, y se determinó la eficacia cisticida a través de la proporción de quistes degenerados sobre el total. Solo se encontraron quistes degenerados en la musculatura, corazón y lengua de los cerdos tratados con OFZ en todos los grupos, lo cual muestra una eficacia del 100%. En los cerebros se encontraron quistes viables y degenerados, con una eficacia menor en todos los grupos (65% [OFZ comercial], 47% [OFZ local 22,5%] y 31% [OFZ local 10%], p = 0,355. Las formulaciones de OFZ producidas localmente fueron igual de efectivas que la formulación comercial y pueden proporcionar una alternativa para el tratamiento de la cisticercosis porcina.

The efficacy of two locally produced oxfendazole (OFZ) formulations against cysticercosis at 22,5% and 10%, versus a commercial formulation (Synanthic 9,06%) was evaluated in twenty-two naturally infected pigs that received a single oral dose of 30 mg/kg. Pigs were sacrificed at eight weeks post-treatment to evaluate the cysts found in their carcasses, and to determine the cysticidal efficacy, which was defined as the proportion of degenerated cysts over total cysts. Only degenerated cysts were found in muscle, heart, and tongue of pigs treated with OFZ in all groups, which shows an efficacy of 100%. Viable and degenerated cysts were found in brains, being the efficacy lower in all groups (65% [commercial OFZ], 47% [local OFZ 22.5%] and 31% [local OFZ 10%], p = 0.355). Locally produced OFZ formulations were similarly effective to the commercial formulation and may provide a practical alternative for the treatment of porcine cysticercosis.

Immune response induced by 14-3-3.3 recombinant protein vaccine of Taenia solium in mice / 中华地方病学杂志

Objective:To explore the potential of Taenia solium (Ts) 14-3-3.3 protein as a candidate molecule for cysticercosis vaccine. Methods:Sixty Kunming mice with the body weight of 18 - 22 g were selected and divided into 3 groups according to their body weight via the random number table method, including normal saline control group (control group), Ts14-3-3.3 recombinant protein vaccine group (vaccine group), and Ts14-3-3.3 recombinant protein vaccine + adjuvant group (vaccine + adjuvant group), with 20 mice in each group. The multi-point subcutaneous injection method was adopted. After the first immunization at 0 week, the booster immunization was carried out twice, a total of 3 times, with an interval of 2 weeks. Four mice in the three groups were killed at 0, 2, 4, 6 and 8 weeks after the first immunization, and the blood of eyeballs and spleen were collected aseptically for serum separation and preparation of spleen lymphocytes suspension [treatment: cell suspension, antigen-stimulate and concanavalin (Con) A-stimulate], respectively. The levels of mouse serum specific immunoglobulin (Ig) G, IgG2a, IgG1 and IgE were detected by indirect enzyme-linked immunosorbent assay (ELISA). The proliferation level of mouse spleen lymphocytes was detected via the CCK-8 method. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-12, IL-13 and IL-10 in culture supernatant of mouse spleen lymphocytes were determined by double-antibody sandwich ELISA.Results:The IgG, IgG2a, and IgG1 levels of the vaccine and vaccine + adjuvant groups immunized for 2 to 8 weeks were higher than those of the control group, and the above indicators of the vaccine + adjuvant group were higher than those of the vaccine group ( P < 0.05). With the same treatment between the groups, the proliferation levels of spleen lymphocytes and the levels of TNF-α, IL-12, IL-13, and IL-10 in the culture supernatant after 2 - 8 weeks of immunization were statistically significantly different ( P < 0.05); the proliferation levels of spleen lymphocytes and the levels of TNF-α, IL-12, IL-13 and IL-10 in the culture supernatant of the vaccine and vaccine + adjuvant groups immunized for 2 to 8 weeks were higher than those of the control group, and the above indicators of the vaccine + adjuvant group were higher than those of the vaccine group ( P < 0.05). When treatment was different in the group, the proliferation levels of spleen lymphocytes and the levels of TNF-α, IL-12, IL-13 and IL-10 in the culture supernatant of the antigen-stimulate and ConA-stimulate were higher than those of the cell suspension, and the above indicators of the ConA-stimulate were higher than those of the antigen-stimulate ( P < 0.05). Conclusion:The recombinant protein vaccine of Ts14-3-3.3 can induce an effective immune response in mice.

Construction of prokaryotic expression system of Taenia solium 14-3-3.2 and its expression at the stages of Taenia solium adult and cysticercus / 中华地方病学杂志

Objective:To establish the prokaryotic expression system of Taenia solium (Ts) 14-3-3.2, and observe the expression of Ts14-3-3.2 protein at the stages of Ts adult and cysticercus. Methods:Based on the Ts14-3-3.2 gene sequence obtained by the Department of Parasitology, Zunyi Medical University in the previous study, the whole gene was synthesized by PCR-based accurate synthesis (PAS) method. After double digestion with restriction enzymes Nde Ⅰ and Xba Ⅰ, the plasmid pCzn1 was ligated to construct a recombinant plasmid pCzn1-Ts14-3-3.2. Then it was transformed into Escherichia coli ArcticExpress competent cells to induce the expression of Ts14-3-3.2 protein. The expression products were analyzed and identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and coomassie blue staining. The purified Ts14-3-3.2 recombinant protein was obtained by Ni-affinity chromatography. New Zealand rabbits were immunized with the recombinant protein to produce Ts14-3-3.2 polyclonal antibody. Western blotting was used to detect the expression of Ts14-3-3.2 protein at the stages of Ts adult and cysticercus. Results:The recombinant plasmid pCzn1-Ts14-3-3.2 was successfully constructed. After induced expression, Ts14-3-3.2 target protein bands appeared in the supernatant and precipitated at the relative molecular weight of about 29.31 × 10 3. The purified Ts14-3-3.2 recombinant protein with His label could be recognized by anti-His monoclonal antibody, and the Ts14-3-3.2 polyclonal antibody with titer of 1 ∶ 512 000 was obtained. Western blotting showed that Ts14-3-3.2 protein was expressed at the stages of Ts adult and cysticercus. Conclusions:The prokaryotic expression system of Ts14-3-3.2 is successfully established, and the Ts14-3-3.2 polyclonal antibody with relatively higher purity and titer is obtained. The Ts14-3-3.2 protein is expressed at the stages of Ts adult and cysticercus.

A Case of Neurocysticercosis in Immigrant Worker Presented with Seizures

@#Neurocysticercosis is an infection of the central nervous system (CNS) by larval stage of Taenia solium (pork tapeworms) called cysticerci. Humans may acquire the infection through ingestion of T. solium embryonated eggs after consuming contaminated undercooked food or water. Being a multiracial country where pig farming is limited and consumption of raw or undercooked food is an uncommon practice, the prevalence of neurocysticercosis in Malaysia is presumably low. However, through immigration and international travel, cases of neurocysticercosis may go underreported. Due to unfamiliarity with the disease, cases of neurocysticercosis also may be missed in Malaysia. Therefore, thorough history taking and physical examinations with high index of suspicion are required by the clinicians to warrant proper investigations in order to meet the diagnosis of neurocysticercosis. Patients diagnosed with neurocysticercosis should be treated cautiously with anthelmintic, to avoid unwanted overwhelming immunological response that can lead to unfavourable outcomes. This is a case report of a foreign worker who presented with first onset of focal seizure associated with intermittent headache.

Neurocisticercosis extraparenquimatosa: reto terapéutico. A propósito de un caso / Extraparenchymal Neurocysticercosis: Therapeutic Challenge. About a Case

Resumen Introducción: La neurocisticercosis es una parasitosis del sistema nervioso central, causada por la ingesta de huevos de Taenia solium. Presenta una alta prevalencia en regiones de Latinoamérica, del Sudeste asiático y África subsahariana, en donde las situaciones insalubres aún prevalecen. Caso clínico: Mujer de 55 años de edad con cuadro clínico de 2 años de evolución, caracterizado por cefaleas de repetición, las cuales se han intensificado últimamente, agregándose crisis convulsivas tónico-clónicas, lo que motivó su ingreso al servicio de urgencias. Los estudios de neuroimágenes (tomografía y resonancia magnética) evidenciaron la presencia de estructuras vesiculares subaracnoideas compatibles con neurocisticercosis. Se instauró tratamiento cestocida, pero la paciente no regresó a sus citas de seguimiento durante 4 años. En su reingreso se presentó muy sintomática y requirió la administración de 8 ciclos más de tratamiento para poder erradicar los parásitos. Discusión: La gran heterogeneidad y no especificidad de los signos y síntomas dificultan el diagnóstico de neurocisticercosis. Es necesario buscar evidencias complementarias de laboratorio y de imagenología para confirmarlo. El tratamiento de esta enfermedad representa un reto para el médico, particularmente cuando el parásito se localiza afuera del parénquima encefálico, en las cisternas del espacio subaracnoideo y sistema ventricular. En menos de un tercio de estos pacientes los parásitos desaparecen con un solo ciclo de tratamiento cestocida. Conclusión: La neurocisticercosis es una enfermedad estrechamente relacionada con la pobreza, pero es prevenible. La investigación relacionada a mejorar los tratamientos sigue siendo necesaria.

Abstract Introduction: Neurocysticercosis is a parasitosis of the central nervous system, caused by the intake of eggs from taenia solium. It has a high prevalence in certain regions of Latin America, the southeast of Asia, and sub-Saharan Africa, where unhealthy situations still prevail. Clinical case: A 55-year-old woman with clinical symptoms of 2 years of evolution, such as recurrent headaches that had increased recently in addition to tonic-clonic seizures. In these conditions she was admitted to the hospital's emergency department. Neuroimaging studies (tomography and magnetic resonance imaging) showed the presence of subarachnoid vesicular structures compatible with neurocysticercosis. Therefore, a cestocidal treatment was administered but the patient did not return to her follow-up appointments for 4 years. When she finally went to her appointment, she was very symptomatic and required the administration of 8 cycles of treatment to eradicate the parasites. Discussion: The great heterogeneity and the non-specificity of the signs and symptoms difficult making a diagnosis of neurocysticercosis. Therefore, it is important to look for complementary laboratory and imaging evidence to confirm it. The treatment of neurocysticercosis represents a challenge for the physician. Particularly, when the parasite is located outside the brain parenchyma, subarachnoid cisterns and ventricular system. In less than a third of these patients the parasites disappear with a single cycle of cestocidal treatment. Conclusion: Neurocysticercosis is a disease closely related to poverty, but it is preventable. Research focused on treatments for neurocysticercosis is still necessary.