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Meshram R, Vaibhav V, S Y, Singh A, Parate S, Khorwal G, Sharma K, Sharma R. Synergistic Manifestations in Cardiac Cysticercosis Complicated by Snake Bite: A Case Report and Literature Review. Cureus 2024; 16:e58789. [PMID: 38784302 PMCID: PMC11112136 DOI: 10.7759/cureus.58789] [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] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Cysticercosis presents a prevalent issue on a global scale. Nevertheless, disseminated cysticercosis (DCC) is infrequent; even rarer is asymptomatic DCC. Here, we present a unique case of asymptomatic DCC involving the heart in a young male who came to medical attention following a fatal snake bite, ultimately leading to his demise. Despite the widespread dissemination of cysticercosis affecting multiple organs, the individual remained asymptomatic for the condition. We present a case of a 23-year-old male who was brought to the emergency department with a history of alleged snake bites. The patient was declared dead upon arrival at the All India Institute of Medical Sciences (AIIMS), Rishikesh, India. Autopsy findings revealed multiple significant cardiac abnormalities, including atheromatous changes with calcification in the root of the aorta and aortic valve, along with numerous collateral vessels originating from the left main coronary artery. Additionally, cystic nodules containing cysticercus larvae were identified within the myocardium, suggesting cardiac cysticercosis. The cause of death was determined to be complications related to the snakebite. This case emphasizes the importance of considering multiple potential etiologies in complex clinical presentations, especially in the tropics.
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Affiliation(s)
- Raviprakash Meshram
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Vikas Vaibhav
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Yashpal S
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashok Singh
- Pathology/Histopathology/Renal Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shailesh Parate
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Gitanjali Khorwal
- Anatomy, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Kshitiza Sharma
- Mental Health Nursing, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Rahul Sharma
- Anatomy, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Kumar S, Shiva, Tewarson V, Hakim MZ, Rahul K, Kumar B, Singh SK. Isolated cardiac cysticercosis of the right ventricle. Indian J Thorac Cardiovasc Surg 2024; 40:99-102. [PMID: 38125329 PMCID: PMC10728406 DOI: 10.1007/s12055-023-01617-1] [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: 07/13/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 12/23/2023] Open
Abstract
Cardiac cysticercosis is a rarely encountered form of cysticercosis, caused by the larval cyst of tapeworm (Taenia solium). It commonly affects the central nervous system; however, systematic involvement has been reported as well. We describe a case of isolated cardiac cysticercosis incidentally discovered in a 16-year-old female undergoing surgical closure of a ventricular septal defect (VSD), with no prior history of parasitic infestation. Our objective is to highlight the importance of cardiac cysticercosis as a differential finding in epicardial cystic masses which may be missed or misinterpreted on imagining modalities and to the limited literature on this particular rate manifestation of cysticercosis.
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Affiliation(s)
- Sarvesh Kumar
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
| | - Shiva
- Department of General Surgery, King George’s Medical University, Lucknow, India
| | - Vivek Tewarson
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
| | - Mohammad Zeeshan Hakim
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
| | - Kumar Rahul
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
| | - Bhupendra Kumar
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
| | - Sushil Kumar Singh
- Department of Cardiovascular and Thoracic Surgery, King George’s Medical University, Lucknow, India
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Dung LT, Van Sy T, Van NT. Solitary cardiac cysticercosis. Radiol Case Rep 2023; 18:2103-2106. [PMID: 37089977 PMCID: PMC10113765 DOI: 10.1016/j.radcr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 04/09/2023] Open
Abstract
Cardiac cysticercosis is rare in clinical practice and is usually accidentally identified during cardiac surgery or autopsies. Although mostly asymptomatic, cardiac cysticercosis could present with severe clinical conditions such as myocarditis, acute myocardial infarction, and arrhythmia. We present a 51-year-old female patient who accidentally discovered a solitary mass in the myocardium. The cardiac magnetic resonance imaging revealed a nonenhanced cyst in the interventricular septum protruding into the right ventricular chamber. Because of cardiac tamponade presenting during a right ventricular endomyocardial biopsy, an emergency open-heart surgery was performed to suture the ventricular wall perforation and remove the tumor. The histopathologic report demonstrated typical cysticercosis. Cardiac cysticercosis is an uncommon lesion and may present with atypical clinical and laboratory features. Therefore, this diagnosis should be considered single or multiple cardiac cystic lesions.
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Gonzalez-Alcaide G, Sosa N, Shevy L, Belinchon-Romero I, Ramos-Rincon JM. Global research on cysticercosis and neurocysticercosis: A bibliometric analysis. Front Vet Sci 2023; 10:1156834. [PMID: 37113561 PMCID: PMC10126342 DOI: 10.3389/fvets.2023.1156834] [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: 02/01/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Background Cysticercosis is a parasitic infection caused by the larval stage Taenia solium. As a neglected tropical disease that is also difficult to diagnose, cysticercosis constitutes an important public health and research challenge. To characterize the development of research on cysticercosis and neurocysticercosis, considering the level of scientific evidence provided and the contribution of different countries to research, according to their endemic nature and their income level. Methods Indexed publications on cysticercosis and neurocysticercosis were retrieved from the MEDLINE database, and the evolution of scientific production and the topic areas addressed in the body of research were analyzed. Results A total of 7,860 papers published between 1928 and 2021 were analyzed. The volume of annual publications increased over time, standing at over 200 documents/year since 2010. Case studies constitute the main study design (27.4% of the documents with available information, n = 2,155), with fewer studies that provide the highest levels of scientific evidence, such as clinical studies (1.9%, n = 149) or systematic reviews (0.8%, n = 63). The most productive journals belong to the Parasitology and Tropical Medicine categories. Although the USA is the most productive country (n = 2,292), countries where Tenia solium is endemic, such as India (n = 1,749), Brazil (n = 941) and Peru (n = 898) also stand out, as does Mexico (n = 1,414). However, other endemic countries in Latin America and sub-Saharan Africa show little participation in the research. The level of international collaboration by country is very uneven, with some countries presenting very low values, such as India (9.9% of documents in international collaboration) or Brazil (18.7%); while there is evidence of intense international collaboration in countries like Peru (91.3%), Tanzania (88.2%) or Kenya (93.1%). Research output has coalesced in three thematic clusters: basic research in animals; parasitism, animal health, and zoonoses; and the diagnosis and therapeutic approach in diseases associated with cysticercosis and neurocysticercosis. Conclusions The generation of knowledge on cysticercosis presents different features from other areas of research, such as the outstanding contribution of only some endemic countries; and the relevance of comprehensive approaches to research (animal and human health). Studies that provide higher levels of scientific evidence should be promoted, as should research in endemic areas.
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Affiliation(s)
| | - Nestor Sosa
- Infectious Diseases Division, Internal Medicine Department, New Mexico University Health Sciences Center, Albuquerque, NM, United States
| | - Laura Shevy
- Infectious Diseases Division, Internal Medicine Department, New Mexico University Health Sciences Center, Albuquerque, NM, United States
| | - Isabel Belinchon-Romero
- Department of Clinical Medicine, Miguel Hernández University, and Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose-Manuel Ramos-Rincon
- Department of Clinical Medicine, Miguel Hernández University, and Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Sharma S, Deora S, Rajagopal R. A Starry Myocardium at CT: Cardiac Cysticercosis. Radiol Cardiothorac Imaging 2022; 4:e220089. [PMID: 36339059 PMCID: PMC9627228 DOI: 10.1148/ryct.220089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/26/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
Supplemental material is available for this article.
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García-Martínez CE, Scatularo CE, Farina JM, Saldarriaga C, Pérez GE, Wyss F, Spina S, Mendoza I, Santi RL, Martínez-Sellés M, Baranchuk A. CYSTICERCOSIS & HEART: A systematic review. Curr Probl Cardiol 2022:101195. [PMID: 35395330 DOI: 10.1016/j.cpcardiol.2022.101195] [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: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/03/2022]
Abstract
Cysticercosis is a parasitic tissue infection caused by larval cysts of the tapeworm Taenia solium. These larval cysts infect brain, muscle, or other tissue, and are a major cause of adult-onset seizures in most low-income countries with tropical climate. Prevalence it's around 50 million people. Although cardiovascular system is not the most affected, this disease can also be associated with multiple and randomly distributed cysts in the subpericardium, subendocardium and myocardium in up to 25% of infected patients. Most cardiac cysticercosis' cases are asymptomatic, but it can manifest with ventricular arrhythmias and conduction disorders. Area Covered: The "Neglected Tropical Diseases and other Infectious Diseases affecting the Heart" (NET-Heart project) is an initiative by the Emerging Leaders group of the Interamerican Society of Cardiology to systematically review all these endemic conditions affecting the heart. A systematic review was conducted following PRISMA guidelines and including articles published in MEDLINE, ScienceDirect, PubMed and LILACS databases. A total of 41 papers were included in this review. Expert Opinion: In the areas of greatest prevalence, unhealthiness and poverty favor the development of this disease, which highlights the need to establish global health policies that reduce morbidity and mortality, economic losses of the affected population, and health costs related to hospitalizations for cardiovascular involvement. Authors provide an algorithm to evaluate the possibility of Cysticercosis' cardiovascular complications.
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Affiliation(s)
| | | | - Juan María Farina
- Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | | | - Fernando Wyss
- Technology and Cardiovascular Service - Cardiosolutions, Guatemala City, Guatemala
| | - Salvador Spina
- Head of Echocardiography and Advisor of the Cardiology Service Central Aeronautical Hospital, Buenos Aires, Argentina
| | - Ivan Mendoza
- Tropical Cardiology, Tropical Medicine Institute. Central University of Venezuela, Caracas, Venezuela
| | - Ricardo Lopez Santi
- Head of promotion and prevention at the Hospital Italiano de La Plata, La Plata, Argentina
| | - Manuel Martínez-Sellés
- Cardiology Department, Hospital General Universitario Gregorio Marañon, CIBERCV. Universidad Europea, Universidad Complutense. Madrid, Spain
| | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canad.
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Himwaze C, Mucheleng'anga LA, Telendiy V, Hamukale A, Tembo J, Kapata N, Ntoumi F, Zumla A. Cardiac cysticercosis and neurocysticercosis in sudden and unexpected community deaths in Lusaka, Zambia: a descriptive medico-legal post-mortem examination study. Int J Infect Dis 2021; 115:195-200. [PMID: 34896266 DOI: 10.1016/j.ijid.2021.11.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cysticercosis is a World Health Organization designated neglected human zoonosis worldwide. Data on cardiac cysticercosis and its contribution to sudden and unexpected community deaths are scarce and require study. METHODS A study was performed of cysticercosis-related deaths and other incidental cases of cysticercosis seen at forensic post-mortem examination over a period of 12 months, in individuals who died suddenly and unexpectedly in the community in Lusaka, Zambia. Whole-body post-mortem examinations were performed according to standard operating procedures for post-mortem examinations. Representative samples were obtained from all body organs and subjected to histopathological examination. Information was obtained on circumstances surrounding the death. Data were collated on patient demographics, history, co-morbidities, pathological gross and microscopic findings, and forensic autopsy cause(s) of death. The available literature on cardiac cysticercosis was also reviewed. RESULTS Nine cases of cysticercosis were identified. Eight of the nine cases had cardiac cysticercosis. There was no prior history of cysticercosis before death. All were male, aged between 28 and 56 years, and from high population density and low socioeconomic communities. There was no community case clustering identified. CONCLUSIONS Cardiac cysticercosis and neurocysticercosis are important incidental findings in sudden and unexpected deaths in the community and can easily be missed antemortem. More investment in forensic autopsy services is required to define the undiagnosed burden of deaths due to treatable communicable diseases.
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Affiliation(s)
- Cordilia Himwaze
- University Teaching Hospital, Department of Pathology and Microbiology, Lusaka, Zambia.
| | - Luchenga Adam Mucheleng'anga
- Ministry of Home Affairs, Office of the State Forensic Pathologist, Lusaka, Zambia; UNZA-UCLMS, PANDORA-ID-NET and HERPEZ R&D Program, University Teaching Hospital, Lusaka, Zambia
| | - Victor Telendiy
- Ministry of Home Affairs, Office of the State Forensic Pathologist, Lusaka, Zambia
| | - Amos Hamukale
- Zambia Field Epidemiology Training Program, Lusaka, Zambia
| | - John Tembo
- UNZA-UCLMS, PANDORA-ID-NET and HERPEZ R&D Program, University Teaching Hospital, Lusaka, Zambia
| | - Nathan Kapata
- UNZA-UCLMS, PANDORA-ID-NET and HERPEZ R&D Program, University Teaching Hospital, Lusaka, Zambia
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Faculty of Sciences and Technology, University Marien Ngouabi, Brazzaville, Republic of Congo
| | - Alimuddin Zumla
- UNZA-UCLMS, PANDORA-ID-NET and HERPEZ R&D Program, University Teaching Hospital, Lusaka, Zambia; Division of Infection and Immunity, University College London; NIHR Biomedical Research Centre, UCLHospitals NHS Foundation Trust, London, UK
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Beyersdorf F, Rylski B. Cysticercosis-rare but important. J Thorac Cardiovasc Surg 2018; 155:e159. [PMID: 29653666 DOI: 10.1016/j.jtcvs.2017.10.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Germany.
| | - Bartosz Rylski
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Germany
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