Report of three imported cases of neurocysticercosis in Guadeloupe.

BACKGROUND: Neurocysticercosis is endemic in most countries of Central and South America but has rarely been described in the French West Indies. We aimed to better understand the clinical and radiological presentation of our cases. CASE PRESENTATION: We report three cases of neurocysticercosis in patients living in Guadeloupe, with different clinical and radiological presentations. CONCLUSION: Given the eventuality of autochtonous transmission, the diagnosis should be considered in all patients living in Guadeloupe presenting with seizures.

O Complexo Teníase Humana-Cisticercose: ainda um sério problema de saúde pública / The Complex Human Taeniasis-Cysticercosis

O presente trabalho tem como objetivo revisar o complexo teníase-cisticercose. Trata-se de um sério problema de saúde pública, representado por entidades zoonóticas das mais importantes naatualidade. O complexo compreende duas doenças distintas, com sintomatologia e epidemiologia totalmente diferentes: a teníase que corresponde à fase final do ciclo do parasita e ocorre apenas no ser humano e a cisticercose que corresponde ao estágio larval da Taenia saginata, a qual parasita bovinos, ou da Taenia solium, que pode acometer suínos e também seres humanos. A cisticercose e a teníase são encontradas com maior frequência em países cujas populações apresentam hábitos de higiene precários e com saneamento básico deficiente. Sua etiologia inclui a Taenia soliume a Taenia saginata que pertencem à classe Cestoidea, ordem Cyclophillidea, família Taenidae e gênero Taenia e as respectivas formas larvares, Cysticercus cellulosae e Cysticercus bovis. Na teníasea sintomatologia clínica é bastante variável, de acordo coma idade e o grau de higidez orgânica do hospedeiro. Em condições naturais, os bovinos acometidos por cisticercose não manifestam sinais clínicos, já na cisticercose humana, variam dependendo da localização dos cisticercos. Quando localizados no sistema nervoso central (neurocisticercose) os sinais clínicos podem variar de acordo com o número de cisticercos, seu estado de desenvolvimento, a variedade morfológica, com sua localização e com as reações que provocam no paciente. O controle da teníase-cisticercose depende das condições econômicas, sociais e culturais de cada região e país, tendo a educação sanitária como ferramenta fundamental.

This paper aims at reviewing the taeniasis-cysticercosis complex disease. It is a disease that represents a serious public health problem, thus becoming one of the most important zoonotic diseases.The complex comprises two distinct diseases, with totally different symptoms and epidemiology: taeniasis that corresponds to the final stage of the parasite cycle and occurs only in humansand cysticercosis that is the larval stage of Taenia saginata, whichis a cattle parasite, and also Taenia solium, which can also affectpigs and humans. Cysticercosis and taeniasis are foundmore frequently in countries whose populations have poor hygieneand poor sanitation. The taeniasis-cysticercosis complex isformed by Taenia solium and Taenia saginata of Cestoda class, Cyclophillidea order, family and gender Taenidae Taenia and theirlarval forms, Cysticercus cellulosae and Cysticercus bovis. Taeniasis, in its clinical symptoms, is highly variable, according to the age and health status of the host. Under natural conditions, animals affected by cysticercosis do not show any clinical signs. On the other hand, human cysticercosis may vary depending on the location of cysticerci. When located in the central nervous system (neurocysticercosis) clinical signs can vary depending on the number of cysticerci, their development stage, morphologicalvariety, its location and the immune response they might cause inthe patient. The control of taeniasis-cysticercosis depends on the economic, social and cultural needs of each region and country, and health education is a fundamental tool.

O Complexo Teníase Humana-Cisticercose: ainda um sério problema de saúde pública / The Complex Human Taeniasis-Cysticercosis

O presente trabalho tem como objetivo revisar o complexo teníase-cisticercose. Trata-se de um sério problema de saúde pública, representado por entidades zoonóticas das mais importantes naatualidade. O complexo compreende duas doenças distintas, com sintomatologia e epidemiologia totalmente diferentes: a teníase que corresponde à fase final do ciclo do parasita e ocorre apenas no ser humano e a cisticercose que corresponde ao estágio larval da Taenia saginata, a qual parasita bovinos, ou da Taenia solium, que pode acometer suínos e também seres humanos. A cisticercose e a teníase são encontradas com maior frequência em países cujas populações apresentam hábitos de higiene precários e com saneamento básico deficiente. Sua etiologia inclui a Taenia soliume a Taenia saginata que pertencem à classe Cestoidea, ordem Cyclophillidea, família Taenidae e gênero Taenia e as respectivas formas larvares, Cysticercus cellulosae e Cysticercus bovis. Na teníasea sintomatologia clínica é bastante variável, de acordo coma idade e o grau de higidez orgânica do hospedeiro. Em condições naturais, os bovinos acometidos por cisticercose não manifestam sinais clínicos, já na cisticercose humana, variam dependendo da localização dos cisticercos. Quando localizados no sistema nervoso central (neurocisticercose) os sinais clínicos podem variar de acordo com o número de cisticercos, seu estado de desenvolvimento, a variedade morfológica, com sua localização e com as reações que provocam no paciente. O controle da teníase-cisticercose depende das condições econômicas, sociais e culturais de cada região e país, tendo a educação sanitária como ferramenta fundamental.(AU)

This paper aims at reviewing the taeniasis-cysticercosis complex disease. It is a disease that represents a serious public health problem, thus becoming one of the most important zoonotic diseases.The complex comprises two distinct diseases, with totally different symptoms and epidemiology: taeniasis that corresponds to the final stage of the parasite cycle and occurs only in humansand cysticercosis that is the larval stage of Taenia saginata, whichis a cattle parasite, and also Taenia solium, which can also affectpigs and humans. Cysticercosis and taeniasis are foundmore frequently in countries whose populations have poor hygieneand poor sanitation. The taeniasis-cysticercosis complex isformed by Taenia solium and Taenia saginata of Cestoda class, Cyclophillidea order, family and gender Taenidae Taenia and theirlarval forms, Cysticercus cellulosae and Cysticercus bovis. Taeniasis, in its clinical symptoms, is highly variable, according to the age and health status of the host. Under natural conditions, animals affected by cysticercosis do not show any clinical signs. On the other hand, human cysticercosis may vary depending on the location of cysticerci. When located in the central nervous system (neurocysticercosis) clinical signs can vary depending on the number of cysticerci, their development stage, morphologicalvariety, its location and the immune response they might cause inthe patient. The control of taeniasis-cysticercosis depends on the economic, social and cultural needs of each region and country, and health education is a fundamental tool.(AU)

Taenia solium DNA is present in the cerebrospinal fluid of neurocysticercosis patients and can be used for diagnosis.

Neurocysticercosis is the most frequent parasitic infection of the CNS and the main cause of acquired epilepsy worldwide. Seizures are the most common symptoms of the disease, together with headache, involuntary movements, psychosis and a global mental deterioration. Absolute diagnostic criteria include the identification of cysticerci, with scolex, in the brain by MRI imaging. We demonstrate here, for the first time, that T. solium DNA is present in the cerebrospinal fluid of patients. The PCR amplification of the parasite DNA in the CSF enabled the correct identification of 29/30 cases (96.7 %). The PCR diagnosis of parasite DNA in the CSF may be a strong support for the diagnosis of neurocysticercosis.

New concepts in the diagnosis and management of neurocysticercosis (Taenia solium).

Human neurocysticercosis, the infection of the nervous system by the larvae of Taenia solium, is a major cause of epileptic seizures and other neurologic morbidity worldwide. The diagnosis and treatment of neurocysticercosis have been considerably improved in recent years. This improvement includes identification and sequencing of specific antigens and development of new assays for laboratory diagnosis, recognition of the frequency and significance of edema around old, calcified cysts (associated to symptomatic episodes), results of a randomized blinded control treatment trial on treatment efficacy for intraparenchymal disease showing a clinical benefit of decreased seizures, and a much better assessment of the frequency and spectrum of cerebrovascular complications. These advances now permit a much better integration of clinical, serologic, and imaging data for diagnosis and therapeutic purposes.