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Padda I, Aziz D, Mahtani A, Sethi Y, Sebastian SA, Sexton J, Karroum P, Fabian D, Fulton M. Recurrent syncopal episodes in a pregnant patient with neurocysticercosis. Radiol Case Rep 2023; 18:3084-3088. [PMID: 37434623 PMCID: PMC10331010 DOI: 10.1016/j.radcr.2023.05.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/15/2023] [Accepted: 05/28/2023] [Indexed: 07/13/2023] Open
Abstract
Neurocysticercosis (NCC) is the most common parasitic infection of the nervous system and acquired epilepsy in low-resource settings due to the pork tapeworm, Taenia solium. Humans contract the intestinal infection of the adult tapeworm (taeniasis) through the fecal-oral route after consuming undercooked food, particularly pork or water, contaminated with tapeworm eggs. When the larvae invades the central nervous system (CNS), the infection causes NCC, which often manifests as late-onset seizures, chronic headaches, and intracranial hypertension. We describe a 31-year-old Hispanic multigravida woman from Guatemala, at 33 weeks of gestation, who presented with multiple syncopal and hypotensive episodes prompting a Computed tomography (CT) image of the head revealing multiple small cerebral calcifications indicating NCC. In this article, we highlight the significance of early symptom recognition and diagnostic workup for NCC in areas with diverse immigrant populations. We also discuss the epidemiology, clinical manifestations, and current treatment modalities available for NCC.
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Affiliation(s)
- Inderbir Padda
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, 355 Bard Ave, Staten Island, NY 10310, USA
| | - Daniel Aziz
- Department of Internal Medicine, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Arun Mahtani
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, 355 Bard Ave, Staten Island, NY 10310, USA
| | - Yashendra Sethi
- Department of Internal Medicine, Government Doon Medical College, Dehradun, India
| | | | - Jaime Sexton
- Department of Medicine, St. George's University, University Centre Grenada, West Indies, Grenada
| | - Paul Karroum
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, 355 Bard Ave, Staten Island, NY 10310, USA
| | - Daniel Fabian
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, 355 Bard Ave, Staten Island, NY 10310, USA
| | - Matthew Fulton
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, 355 Bard Ave, Staten Island, NY 10310, USA
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Sakhuja A, Kc S, Wortsman J, Shrestha DB, Aryal BB, Kwatra V, Verda L. Severe Neurocysticercosis in an Immunocompetent Male Without Travel to an Endemic Region: A Case Report. Cureus 2023; 15:e34870. [PMID: 36923196 PMCID: PMC10010573 DOI: 10.7759/cureus.34870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/26/2023] [Indexed: 02/13/2023] Open
Abstract
Neurocysticercosis is a neglected parasitic cause of seizures in the United States. It can have a wide array of presentations depending on the location and number of cysticercoids. The severity of symptoms varies with the location of the lesion in the brain and to the extent of the number of neurocysticercoids and host immune response. In the severe form of neurocysticercosis, it can present as an acute encephalitic picture. We present a case of severe neurocysticercosis in a patient without any significant travel history. Neurocysticercosis in nonendemic areas can be diagnostically challenging, given the lack of travel history as in our patient. Neurocysticercosis should be kept as a differential in all cases of seizures without prior history of seizure episodes.
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Affiliation(s)
- Anuradha Sakhuja
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Sharada Kc
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Joshua Wortsman
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Dhan B Shrestha
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Barun B Aryal
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Vishal Kwatra
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Larissa Verda
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
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3
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Human Neurocysticercosis: An Overview. Pathogens 2022; 11:pathogens11101212. [PMID: 36297269 PMCID: PMC9607454 DOI: 10.3390/pathogens11101212] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/20/2022] Open
Abstract
Human cysticercosis is caused by ingestion of T. solium eggs from taenia carriers. Neurocysticercosis (NCC), defined as the infection of the CNS and the meninges by the larval stage of Taenia solium, is the most common helminthic infection of the CNS worldwide. Parasites may lodge in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing pathological changes that account for the pleomorphism of this disease. Seizures/epilepsy are the most common clinical manifestation, but other patients present with headache, focal deficits, intracranial hypertension, or cognitive decline. Accurate diagnosis of NCC is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunological tests. However, neuroimaging studies are fundamental for diagnosis because immunological test and clinical manifestations only provide circumstantial evidence of NCC. The introduction of cysticidal drugs changed the prognosis of most NCC patients. These drugs have been shown to reduce the burden of infection and to improve the clinical course of the disease in many patients. Efforts should be directed to eradicate the disease through the implementation of control programs against all the steps in the life cycle of T. solium, including carriers of the adult tapeworm, infected pigs, and eggs in the environment.
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Neurocysticercosis in the Tropics (and Beyond). CURRENT TROPICAL MEDICINE REPORTS 2022. [DOI: 10.1007/s40475-022-00269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bustos J, Gonzales I, Saavedra H, Handali S, Garcia HH. Neurocysticercosis. A frequent cause of seizures, epilepsy, and other neurological morbidity in most of the world. J Neurol Sci 2021; 427:117527. [PMID: 34147957 PMCID: PMC8800347 DOI: 10.1016/j.jns.2021.117527] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 12/07/2022]
Abstract
Neurocysticercosis is endemic in most of the world and in endemic areas it accounts for approximately 30% of cases of epilepsy. Appropriate diagnosis and management of neurocysticercosis requires understanding the diverse presentations of the disease since these will vary in regards to clinical manifestation, sensitivity of diagnostic tests, and most importantly, therapeutic approach. This review attempts to familiarize tropical neurology practitioners with the diverse types of neurocysticercosis and the more appropriate management approaches for each.
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Affiliation(s)
- J Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - I Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - H Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - S Handali
- Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - H H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
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6
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Management of Neurocysticercosis in Children: Association of Child Neurology Consensus Guidelines. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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7
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Gómez-Morales MÁ, Pezzotti P, Ludovisi A, Boufana B, Dorny P, Kortbeek T, Blocher J, Schmidt V, Amati M, Gabriël S, Pozio E, Winkler AS, Participants TRT. Collaborative Studies for the Detection of Taenia spp. Infections in Humans within CYSTINET, the European Network on Taeniosis/Cysticercosis. Microorganisms 2021; 9:1173. [PMID: 34072437 PMCID: PMC8229687 DOI: 10.3390/microorganisms9061173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022] Open
Abstract
Laboratory tools for diagnosing taeniosis/cysticercosis in non-endemic countries are available; however, there is little data on their performance. To provide information on the sensitivity, specificity, and reproducibility of these tools, inter-laboratory studies were organized within the EU COST-Action CYSTINET (TD1302). Two serological and one coprological Ring Trials (RTs) were organized to test a panel of human-derived sera and stool samples using assays routinely conducted by the participating laboratories to detect Taenia spp. infections. Four Western blots (WBs) and five ELISAs were used by nine laboratories for cysticercosis diagnosis. In the first serological RT, the overall sensitivity was 67.6% (95% CI, 59.1-75.4), whereas specificity was 97% (95% CI, 89.8-99.6). WBs recorded the best accuracy. A second serological RT was organized, to assess the three tests most frequently used during the first RT. Two out of six laboratories performed all the three tests. The overall sensitivity and specificity were 52.8% (95% CI, 42.8-62.7) and 98.1% (95% CI, 93.2-99.7), respectively. Laboratory performance strongly affected test results. Twelve laboratories participated in the coprological RT using conventional microscopy and six laboratories used molecular assays. Traditional diagnosis by microscopy yielded better results than molecular diagnosis. This may have been influenced by the lack of standardization of molecular tests across participating laboratories.
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Affiliation(s)
- María Ángeles Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Alessandra Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Belgees Boufana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
- National Reference Laboratory for Trichinella & Echinococcus National Wildlife Management Centre (NWMC) Animal and Plant Health Agency Sand Hutton, York YO41 1LZ, UK
| | - Pierre Dorny
- Veterinary Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerpen, Belgium;
| | - Titia Kortbeek
- Center IDS, National Institute of Public Health and the Environment, RIVM, 3720 Bilthoven, The Netherlands;
| | - Joachim Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria;
| | - Veronika Schmidt
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
| | - Marco Amati
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium;
| | - Edoardo Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (P.P.); (A.L.); or (B.B.); (M.A.); (E.P.)
| | - Andrea Sylvia Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, 81675 Munich, Germany; (V.S.); (A.S.W.)
- Centre for Global Health, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
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Butala C, Brook TM, Majekodunmi AO, Welburn SC. Neurocysticercosis: Current Perspectives on Diagnosis and Management. Front Vet Sci 2021; 8:615703. [PMID: 34041288 PMCID: PMC8141574 DOI: 10.3389/fvets.2021.615703] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
Porcine cysticercosis, human taeniasis, and (neuro)cysticercosis are endemic in many low- and middle-income countries (LMIC) where they present a significant health burden to affected communities. Neurocysticercosis (NCC) is one of the leading causes of human epilepsy in many hyperendemic regions in Latin America, Asia, and sub-Saharan Africa. The World Health Organization (WHO) reports an estimated 2.5-8.3 million cases of NCC annually with a disability-adjusted life year (DALY) burden of 2.8 million, but as for all neglected tropical diseases (NTDs), these values are likely to be underestimated. Diagnosis of NCC is complex and most accurately diagnosed using clinical neuroimaging that is unavailable in most hyperendemic regions in LMIC. On January 28, 2021, WHO will launch its road map for the NTDs' "Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030." Taeniasis/cysticercosis is targeted for control success considered as steady increase in the number of countries with intensified control in hyperendemic areas [increasing from 2 (3%) in 2020 to 4 (6%) in 2023, to 9 (14%) by 2025, and to 17 (27%) by 2030]. Cross-cutting targets that include 100% access to at least basic water supply, sanitation, and hygiene in areas endemic for NTDs and 75% integrated treatment coverage for preventative chemotherapy will additionally impact on the taeniasis/cysticercosis/NCC complex. With no vaccine available for humans, prevention of infection depends on communication to the public of the life cycle of a complex zoonosis to promote behavior change, underpinned by practical control measures including treatment of human taeniasis and (neuro)cysticercosis with albendazole and praziquantel [widely used as part of the mass drug administration (MDA) deworming programs], surgery where appropriate, and effective vaccination and deworming for pigs supported by meat inspection. Here, we review recent advances in tools and implementation for Taenia solium taeniasis/(neuro)cysticercosis (TSTC) control and milestones on the onward path to elimination.
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Affiliation(s)
- Caitlin Butala
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - T. M. Brook
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Ayodele O. Majekodunmi
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Susan Christina Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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Evaluation of Taenia solium cyst fluid-based enzyme linked immunoelectro transfer blot for Neurocysticercosis diagnosis in urban and highly endemic rural population of North India. Clin Chim Acta 2020; 508:16-21. [DOI: 10.1016/j.cca.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 01/05/2023]
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Garcia HH, Gonzalez AE, Gilman RH. Taenia solium Cysticercosis and Its Impact in Neurological Disease. Clin Microbiol Rev 2020; 33:e00085-19. [PMID: 32461308 PMCID: PMC7254859 DOI: 10.1128/cmr.00085-19] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
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Affiliation(s)
- Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E Gonzalez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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Herrador Z, Pérez-Molina JA, Henríquez Camacho CA, Rodriguez-Guardado A, Bosch-Nicolau P, Calabuig E, Domínguez-Castellano A, Pérez-Jacoiste MA, Ladrón de Guevara MC, Mena A, Ruiz-Giardin JM, Torrús D, Wikman-Jorgensen P, Benito A, López-Vélez R. Imported cysticercosis in Spain: A retrospective case series from the +REDIVI Collaborative Network. Travel Med Infect Dis 2020; 37:101683. [PMID: 32335208 DOI: 10.1016/j.tmaid.2020.101683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/21/2020] [Accepted: 04/17/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Neurocysticercosis (NCC) is the most common parasitic neurological disease worldwide and a major cause of epilepsy. Spain is the country reporting the highest number of NCC imported cases in Europe. METHODOLOGY Retrospective case series of NCC patients registered in the +REDIVI Network from October 1, 2009 to July 2018. A specific questionnaire, including clinical and diagnostic characteristics, was created and sent to the collaborator centers. RESULTS 46 cases were included in the analysis. 55% were male, mean age of 40 years. 95.6% were migrants. The median duration since migration from an endemic area was 10 years. Predominant nationalities were Ecuadorians (50%) and Bolivians (30.4%). Frequent locations were parenchymal (87%), subarachnoid (26.1%) and intraventricular cysts (10.9%). Serological analysis was performed in 91.3%, being 54.8% positive. Most prevalent clinical manifestations were persistent headache (60.9%), epilepsy (43.5%) and visual changes (13%). Patients were mainly treated with albendazole (76.1%), corticosteroids (67.4%), and anticonvulsionants (52.2%). 82.5% had a favorable clinical outcome. CONCLUSIONS Most NCC cases were long-standing migrants. Few clinical differences were observed depending on the cysticerci location. The treatment was often not according to current recommendations, and no uniform criteria were followed when it came to the therapeutic regimen. NCC case management in Spain (including clinician awareness and laboratory capacity improvements) needs to be strengthened.
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Affiliation(s)
- Zaida Herrador
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain; Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain.
| | - José A Pérez-Molina
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain; National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRICYS, Madrid, Spain
| | - César Augusto Henríquez Camacho
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRICYS, Madrid, Spain
| | | | | | | | | | | | | | - Ana Mena
- Hospital Universitario Son Espases, Palma Mallorca, Spain
| | | | - Diego Torrús
- Hospital Universitario de Alicante, Alicante, Spain
| | - Philip Wikman-Jorgensen
- Hospital Universitario de Elda, Alicante, Spain; Foundation for the Promotion of Health and Biomedical Research of Valencia Region, FISABIO, Spain
| | - Agustín Benito
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain; Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
| | - Rogelio López-Vélez
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain; National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRICYS, Madrid, Spain
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White AC, Coyle CM, Rajshekhar V, Singh G, Hauser WA, Mohanty A, Garcia HH, Nash TE. Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2019; 66:e49-e75. [PMID: 29481580 DOI: 10.1093/cid/cix1084] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/19/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Hector H Garcia
- Instituto Nacional de Ciencias Neurologicas and Universidad Peruana Cayetano Heredia, Lima, Peru
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Zammarchi L, Angheben A, Fantoni T, Chiappini E, Mantella A, Galli L, Marchese V, Zavarise G, Bisoffi Z, Bartoloni A. Screening for neurocysticercosis in internationally adopted children: yield, cost and performance of serological tests, Italy, 2001 to 2016. ACTA ACUST UNITED AC 2019; 23. [PMID: 30301492 PMCID: PMC6178589 DOI: 10.2807/1560-7917.es.2018.23.40.1700709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neurocysticercosis (NCC) is one of the leading causes of epilepsy worldwide. The majority of cases in Europe are diagnosed in immigrants. Currently in Italy, routine serological screening for cysticercosis is recommended for internationally adopted children (IAC) coming from endemic countries. Methods: We retrospectively analyse the results of the serological screening for cysticercosis in IAC 16 years old or younger, attending two Italian third level paediatric clinics in 2001–16. Results: Of 2,973 children included in the study, 2,437 (82.0%) were screened by enzyme-linked immune electro transfer blot (EITB), 1,534 (51.6%) by ELISA, and 998 (33.6%) by both tests. The seroprevalence of cysticercosis ranged between 1.7% and 8.9% according to EITB and ELISA, respectively. Overall, 13 children were diagnosed with NCC accounting for a NCC frequency of 0.4% (95% confidence interval (CI): 0.2–0.6%). Among the 168 seropositive children, only seven (4.2%) were diagnosed with NCC. Of these children, three were asymptomatic and four presented epilepsy. Among seronegative children (n = 2,805), seven presented with neurological symptoms that lead to the diagnosis of NCC in six cases. The sensitivity, specificity, positive and negative predictive value for the diagnosis of NCC were 54.5%, 98.6%, 14.6%, 99.8% for EITB and 22.2%, 91.1%, 1.4%, 99.5% for ELISA. The yield of the screening programme was 437 NCC cases per 100,000. The number needed to screen to detect one NCC case was 228. The cost per NCC case detected was EUR 10,372. Conclusion: On the base of our findings we suggest the ongoing serological screening for cysticercosis to be discontinued, at least in Italy, until further evidence in support will be available.
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Affiliation(s)
- Lorenzo Zammarchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Angheben
- Centre for Tropical Diseases, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Teresa Fantoni
- Health Human Sciences School, Medicine and Surgery Degree Course, University of Florence, Florence, Italy
| | - Elena Chiappini
- Infectious Disease Unit, Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Antonia Mantella
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Luisa Galli
- Infectious Disease Unit, Meyer University Hospital, Department of Health Science, University of Florence, Florence, Italy
| | - Valentina Marchese
- University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB elimination, University of Brescia, Brescia, Italy.,Centre for Tropical Diseases, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giorgio Zavarise
- Department of Pediatrics, Hospital Sacro Cuore - Don Calabria, Negrar, Italy
| | - Zeno Bisoffi
- Centre for Tropical Diseases, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Alessandro Bartoloni
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Hernández M, Astudillo OG, Diego G, de-la-Rosa-Arana JL, Meza-Lucas A, García-Rodea R, Romo ML, Toledo A, Parkhouse RME, Garate T, Sciutto E, Fleury A. Immunodiagnosis of human neurocysticercosis: comparative performance of serum diagnostic tests in Mexico. Parasitol Res 2019; 118:2891-2899. [PMID: 31418112 DOI: 10.1007/s00436-019-06425-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/07/2019] [Indexed: 11/28/2022]
Abstract
Immunodiagnosis has a supportive role in the diagnosis of neurocysticercosis (NCC). The aim of this study was to compare the validity of seven immunodiagnostic tests among serum samples from 58 patients with NCC, 26 patients with neurological diseases other than NCC, and 15 healthy controls. One test for viable parasite detection (HP10 antigen assay) and six for antibody detection were evaluated. For the entire sample, sensitivities ranged from 55.2% (NOVALISA) to 81.0% (enzyme-linked immunosorbent assay [ELISA] Taenia solium antibody), with the sensitivity of the latter test significantly higher than that of the in-house ELISA Taenia crassiceps, NOVALISA, enzyme-linked immunoelectrotransfer blot (EITB) CDC, and HP10. Overall, specificities were high, ranging from 85.4% (ELISA Ts) to 97.1% (NOVALISA), with no statistically significant differences. Detection of HP10 antigen was significantly associated with the presence of vesicular parasites. The simple and low-cost ELISA Taenia solium antibody Ab instead of EITB is recommended to support NCC diagnosis in both rural and hospital settings in Mexico.
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Affiliation(s)
- Marisela Hernández
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México, Mexico
| | - Osvaldo-Germán Astudillo
- Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. Carlos Malbrán", Buenos Aires, Argentina
| | - Gustavo Diego
- Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) "Dr. Carlos Malbrán", Buenos Aires, Argentina
| | - Jorge-Luis de-la-Rosa-Arana
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Secretaria de Salud, Ciudad de México, Mexico
| | - Antonio Meza-Lucas
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Secretaria de Salud, Ciudad de México, Mexico
| | - Ricardo García-Rodea
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Secretaria de Salud, Ciudad de México, Mexico
| | - Matthew-L Romo
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, Hong Kong
| | - Andrea Toledo
- Unidad de Neuroinflamación, Instituto de Investigaciones Biomédicas-UNAM/Instituto Nacional de Neurología y Neurocirugía/Facultad de Medicina-UNAM, Ciudad de México, Mexico
| | | | - Teresa Garate
- Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Edda Sciutto
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México, Mexico
| | - Agnès Fleury
- Unidad de Neuroinflamación, Instituto de Investigaciones Biomédicas-UNAM/Instituto Nacional de Neurología y Neurocirugía/Facultad de Medicina-UNAM, Ciudad de México, Mexico.
- Neurocysticercosis Clinic, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, Mexico.
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15
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Metastatic malignancy masquerading as neurocysticercosis. IDCases 2019; 18:e00596. [PMID: 31372339 PMCID: PMC6660454 DOI: 10.1016/j.idcr.2019.e00596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/20/2022] Open
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16
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Symeonidou I, Arsenopoulos K, Tzilves D, Soba B, Gabriël S, Papadopoulos E. Human taeniasis/cysticercosis: a potentially emerging parasitic disease in Europe. Ann Gastroenterol 2018; 31:406-412. [PMID: 29991885 PMCID: PMC6033766 DOI: 10.20524/aog.2018.0260] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/30/2018] [Indexed: 12/04/2022] Open
Abstract
Taenia saginata (T. saginata)/Taenia solium (T. solium) taeniasis/cysticercosis disease complexes remain a significant challenge for food safety and public health. Human taeniasis is an infectious disease caused by the ingestion of the metacestode larval stage, the cysticerci of T. saginata in beef or T. solium in pork. Humans can also become infected via the ingestion of T. solium eggs. In this case, the cysticerci can establish in the central nervous system, causing the infection called neurocysticercosis. T. solium is of higher importance than T. saginata because the former species can cause neurocysticercosis in humans, a major cause of neurological morbidity in the world. The taeniasis/cysticercosis complex is included in the list of neglected zoonotic diseases by the World Health Organization and Food and Agriculture Organization, with T. solium being the number one foodborne parasite; it occurs mostly in developing countries, such as regions of Asia, Africa and Latin America, where the disease remains endemic. Long absent in Western Europe and other developed countries, cysticercosis has been recently re-emerged as a result of immigration, travel and commerce. In this review, cysticercosis is presented with special emphasis on some aspects of this neglected disease: the main clinical manifestations, risk factors and epidemiology. In addition, any recent advances in diagnostic approaches and treatment are discussed. Finally, the complexities involved in the control of the disease and the need to revise current management strategies are highlighted.
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Affiliation(s)
- Isaia Symeonidou
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
| | - Konstantinos Arsenopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
| | - Dimitrios Tzilves
- Gastroenterology Department, Theageneio Hospital, Thessaloniki, Greece (Dimitrios Tzilves)
| | - Barbara Soba
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia (Barbara Soba)
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium (Sarah Gabriël)
| | - Elias Papadopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece (Isaia Symeonidou, Konstantinos Arsenopoulos, Elias Papadopoulos)
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17
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White AC, Coyle CM, Rajshekhar V, Singh G, Hauser WA, Mohanty A, Garcia HH, Nash TE. Diagnosis and Treatment of Neurocysticercosis: 2017 Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Am J Trop Med Hyg 2018; 98:945-966. [PMID: 29644966 PMCID: PMC5928844 DOI: 10.4269/ajtmh.18-88751] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
| | | | | | | | | | - Aaron Mohanty
- University of Texas Medical Branch, Galveston, Texas
| | - Hector H Garcia
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto Nacional de Ciencias Neurologicas, Lima, Peru
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18
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Abstract
The normal physiologic changes during pregnancy contribute to nutritional, metabolic, and immunologic adjustments, which can have an impact on the presentation of several diseases. New onset seizures during pregnancy and the postpartum can be attributed to several etiologies. Patient demographic data as well as personal and social histories are key in determining the etiology of new onset seizures. Neurocysticercosis (NCC), a commonly overlooked etiology, must be included in the differential diagnosis of patients with new onset seizures coming from NCC endemic areas. The diagnosis is based on a combination of clinical findings, exposure history, imaging, and serology. We present two cases of patients with NCC that became symptomatic during pregnancy or postpartum period. We will review the epidemiology, clinical manifestations, and management of NCC in pregnancy.
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Affiliation(s)
- Camille Webb
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Mauricio La Rosa
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Gayle Olson
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Miguel Cabada
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
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19
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Garcia HH, Castillo Y, Gonzales I, Bustos JA, Saavedra H, Jacob L, Del Brutto OH, Wilkins PP, Gonzalez AE, Gilman RH. Low sensitivity and frequent cross-reactions in commercially available antibody detection ELISA assays for Taenia solium cysticercosis. Trop Med Int Health 2017; 23:101-105. [PMID: 29160912 DOI: 10.1111/tmi.13010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the diagnostic performance of two commercially available ELISA kits, Novalisa® and Ridascreen® , for the detection of antibodies to Taenia solium, compared to serological diagnosis of neurocysticercosis (NCC) by LLGP-EITB (electro-immunotransfer blot assay using lentil-lectin purified glycoprotein antigens). METHODS Archive serum samples from patients with viable NCC (n = 45) or resolved, calcified NCC (n = 45), as well as sera from patients with other cestode parasites (hymenolepiasis, n = 45 and cystic hydatid disease, n = 45), were evaluated for cysticercosis antibody detection using two ELISA kits, Novalisa® and Ridascreen® . All NCC samples had previously tested positive, and all samples from heterologous infections were negative on LLGP-EITB for cysticercosis. Positive rates were calculated by kit and sample group and compared between the two kits. RESULTS Compared to LLGP-EITB, the sensitivity of both ELISA assays to detect specific antibodies in patients with viable NCC was low (44.4% and 22.2%), and for calcified NCC, it was only 6.7% and 4.5%. Sera from patients with cystic hydatid disease were highly cross-reactive in both ELISA assays (38/45, 84.4%; and 25/45, 55.6%). Sera from patients with hymenolepiasis cross-reacted in five cases in one of the assays (11.1%) and in only one sample with the second assay (2.2%). CONCLUSIONS The performance of Novalisa® and Ridascreen® was poor. Antibody ELISA detection cannot be recommended for the diagnosis of neurocysticercosis.
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Affiliation(s)
- Hector H Garcia
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru.,Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Yesenia Castillo
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Isidro Gonzales
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Javier A Bustos
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Herbert Saavedra
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Louis Jacob
- Faculty of Medicine, University of Paris, Paris, France
| | - Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
| | | | - Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Robert H Gilman
- Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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20
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Gómez-Morales MA, Gárate T, Blocher J, Devleesschauwer B, Smit GSA, Schmidt V, Perteguer MJ, Ludovisi A, Pozio E, Dorny P, Gabriël S, Winkler AS. Present status of laboratory diagnosis of human taeniosis/cysticercosis in Europe. Eur J Clin Microbiol Infect Dis 2017; 36:2029-2040. [PMID: 28669015 PMCID: PMC5653711 DOI: 10.1007/s10096-017-3029-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/23/2017] [Indexed: 11/08/2022]
Abstract
Human cysticercosis (CC) is a parasitic zoonosis caused by the larval stage (cyst) of the Taenia solium. Cysts can establish in the human central nervous system (neurocysticercosis, NCC) and other organs and tissues; they also develop in pigs, the natural intermediate host. Human taeniosis may be caused by T. solium, Taenia saginata and Taenia asiatica tapeworms; these infections are usually asymptomatic, but show a significant relevance as they perpetuate the parasites’ life cycle, and, in the case of T. solium, they are the origin of (N)CC. In European Union (EU) member states and associated countries, the occurrence of autochthonous T. solium cases is debated, and imported cases have significantly increased lately; the status of T. asiatica has been never reported, whereas T. saginata is prevalent and causes an economic impact due to condemned carcasses. Based on their effects on the EU society, the specific diagnosis of these pathologies is relevant for their prevention and control. The aims of this study were to know the diagnostic tests used in European laboratories for human taeniosis/cysticercosis by means of a questionnaire, to determine potential gaps in their detection, and to obtain preliminary data on the number of diagnosed taeniosis/CC cases.
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Affiliation(s)
- M A Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy.
| | - T Gárate
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain.
| | - J Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - B Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - G S A Smit
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.,Faculty of Veterinary Medicine, Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.,Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - V Schmidt
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - M J Perteguer
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain
| | - A Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - E Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - P Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - S Gabriël
- Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Ghent University, Ghent, Belgium
| | - A S Winkler
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany. .,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway.
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21
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Wu HW, Ito A, Ai L, Zhou XN, Acosta LP, Lee Willingham A. Cysticercosis/taeniasis endemicity in Southeast Asia: Current status and control measures. Acta Trop 2017; 165:121-132. [PMID: 26802488 DOI: 10.1016/j.actatropica.2016.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/02/2015] [Accepted: 01/10/2016] [Indexed: 12/26/2022]
Abstract
The parasitic zoonoses cysticercosis/taeniasis is among the 17 major Neglected Tropical Diseases (NTDs) identified by the WHO as a focus for research and control. It is caused by a larval stage (cysticercus) infection of Taenia solium tapeworm in both humans and pigs. Cysticercosis occurs in many resource-poor countries, especially those with warm and mild climates in the regions of Latin America (LA), Asia and Sub-Saharan Africa (SSA). The prevalence of human cysticercosis is marked in those areas where individuals are traditionally keen to consume raw or insufficiently cooked pork and/or where the husbandry of pigs is improper. The worldwide burden of cysticercosis is unclear and notably, large-scale control initiatives are lacking in all regions. This review focuses on the current endemic status of cysticercosis caused by T. solium infection in both humans and pigs living in 13 Southeast Asian countries. We will also emphasize epidemiological data as well as prevention and control of human neurocysticercosis.
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Affiliation(s)
- Hai-Wei Wu
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, RI, USA; Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence, RI, USA.
| | - Akira Ito
- Department of Parasitology and Neglected Tropical Diseases Research Laboratory, Asahikawa Medical University, Asahikawa, Japan
| | - Lin Ai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Luz P Acosta
- Department of Immunology, Research Institute for Tropical Medicine, Alabang, Muntinlupa, Philippines
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies
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22
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Abstract
Neurocysticercosis is an important cause of seizures worldwide and is endemic in most of Latin America, Sub-Saharan Africa, Southeast Asia, India, and China. Neurocysticercosis has profoundly different disease manifestations varying from asymptomatic presentation to life-threatening hydrocephalus. Clinical manifestations, pathogenesis, diagnostic methods, and optimal treatment vary with the location, number of lesions, and host response. Diagnosis is based on a combination of clinical presentation, neuroimaging findings, history of exposure, and serologic testing. Initial therapy should be focused on symptom management including seizure control and management of increased intracranial pressure. Emerging data are demonstrating that the optimal management approach varies with stage. Single enhancing or cystic lesions should be treated with albendazole and steroids. Patients with more than two cystic lesions should be treated with combination therapy with albendazole and praziquantel, whereas patients with hydrocephalus benefit from surgical management, especially with minimally invasive approaches.
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Affiliation(s)
- Camille M Webb
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, 301 University Boulevard, Rt 0435, Galveston, TX, 77555-0435, USA
| | - A Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, 301 University Boulevard, Rt 0435, Galveston, TX, 77555-0435, USA.
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23
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Taenia solium porcine cysticercosis in Madagascar: Comparison of immuno-diagnostic techniques and estimation of the prevalence in pork carcasses traded in Antananarivo city. Vet Parasitol 2016; 219:77-83. [DOI: 10.1016/j.vetpar.2015.08.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 08/19/2015] [Accepted: 08/22/2015] [Indexed: 11/22/2022]
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24
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Ntoukas V, Tappe D, Pfütze D, Simon M, Holzmann T. Cerebellar cysticercosis caused by larval Taenia crassiceps tapeworm in immunocompetent woman, Germany. Emerg Infect Dis 2014; 19:2008-11. [PMID: 24274258 PMCID: PMC3840866 DOI: 10.3201/eid1912.130284] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Human cysticercosis caused by Taenia crassiceps tapeworm larvae involves the muscles and subcutis mostly in immunocompromised patients and the eye in immunocompetent persons. We report a successfully treated cerebellar infection in an immunocompetent woman. We developed serologic tests, and the parasite was identified by histologic examination and 12s rDNA PCR and sequencing.
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25
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Development of specific scFv antibodies to detect neurocysticercosis antigens and potential applications in immunodiagnosis. Immunol Lett 2013; 156:59-67. [DOI: 10.1016/j.imlet.2013.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/20/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022]
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26
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Diaz-Masmela Y, Fragoso G, Ambrosio JR, Mendoza-Hernández G, Rosas G, Estrada K, Carrero JC, Sciutto E, Laclette JP, Bobes RJ. Immunodiagnosis of porcine cysticercosis: identification of candidate antigens through immunoproteomics. Vet J 2013; 198:656-60. [PMID: 24161749 DOI: 10.1016/j.tvjl.2013.09.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 01/12/2023]
Abstract
Cysticercosis, caused by the larval stage of Taenia solium, is a zoonotic disease affecting pigs and humans that is endemic to developing countries in Latin America, Africa and South East Asia. The prevalence of infection in pigs, the intermediate host for T. solium, has been used as an indicator for monitoring disease transmission in endemic areas. However, accurate and specific diagnostic tools for porcine cysticercosis remain to be established. Using proteomic approaches and the T. solium genome sequence, seven antigens were identified as specific for porcine cysticercosis, namely, tropomyosin 2, alpha-1 tubulin, beta-tubulin 2, annexin B1, small heat-shock protein, 14-3-3 protein, and cAMP-dependent protein kinase. None of these proteins were cross-reactive when tested with sera from pigs infected with Ascaris spp., Cysticercus tenuicollis and hydatid cysts of Echinococcus spp. or with serum from a Taenia saginata-infected cow. Comparison with orthologues, indicated that the amino acid sequences of annexin B1 and cAMP-dependent protein kinase possessed highly specific regions, which might make them suitable candidates for development of a specific diagnostic assay for porcine cysticercosis.
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Affiliation(s)
- Yuliet Diaz-Masmela
- Immunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, DF 04510, Mexico
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27
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Habib I, Smolarek D, Hattab C, Grodecka M, Hassanzadeh-Ghassabeh G, Muyldermans S, Sagan S, Gutiérrez C, Laperche S, Le-Van-Kim C, Aronovicz YC, Wasniowska K, Gangnard S, Bertrand O. VHH (nanobody) directed against human glycophorin A: A tool for autologous red cell agglutination assays. Anal Biochem 2013; 438:82-9. [DOI: 10.1016/j.ab.2013.03.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/12/2013] [Accepted: 03/15/2013] [Indexed: 01/01/2023]
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28
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Nothing is perfect! Trouble-shooting in immunological and molecular studies of cestode infections. Parasitology 2013; 140:1551-65. [PMID: 23790247 DOI: 10.1017/s0031182013000966] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This personal review focuses on ways to approach and overcome some of the more common issues encountered while studying cestode zoonoses. The information presented here is based on the author's own experiences with immunological and molecular approaches for the detection of these parasites. There are many incongruities between immunological and molecular studies due to biased work. Nothing is perfect. Indirect approaches using either immunological, or even molecular tools, are limited without confirmation from direct evidence of infection. The dilemma of whether developing countries should develop their own diagnostic tests or rely on commercially available kits is also discussed.
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