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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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Laranjo-González M, Devleesschauwer B, Trevisan C, Allepuz A, Sotiraki S, Abraham A, Afonso MB, Blocher J, Cardoso L, Correia da Costa JM, Dorny P, Gabriël S, Gomes J, Gómez-Morales MÁ, Jokelainen P, Kaminski M, Krt B, Magnussen P, Robertson LJ, Schmidt V, Schmutzhard E, Smit GSA, Šoba B, Stensvold CR, Starič J, Troell K, Rataj AV, Vieira-Pinto M, Vilhena M, Wardrop NA, Winkler AS, Dermauw V. Epidemiology of taeniosis/cysticercosis in Europe, a systematic review: Western Europe. Parasit Vectors 2017; 10:349. [PMID: 28732550 PMCID: PMC5521153 DOI: 10.1186/s13071-017-2280-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. METHODS We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. RESULTS Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata, although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002-7.82%. CONCLUSIONS Detection and reporting of taeniosis in western Europe should be improved. The existence of T. solium tapeworm carriers, of suspected autochthonous cases of human cysticercosis and the lack of confirmation of porcine cysticercosis cases deserve further attention. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniosis and human cysticercosis should be notifiable and surveillance in animals should be improved.
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Affiliation(s)
- Minerva Laranjo-González
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain.
| | - Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Chiara Trevisan
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Alberto Allepuz
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain.,Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain
| | - Smaragda Sotiraki
- Veterinary Research Institute, HAO-DEMETER, Campus Thermi, 57001, Thessaloniki, Greece
| | - Annette Abraham
- Centre for Global Health, Department of Neurology, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany.,Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - Mariana Boaventura Afonso
- Divisão de Proteção Veterinária e Pecuária, Direção de Serviços de Alimentação e Veterinária, Direção Regional de Agricultura, Secretaria Regional de Agricultura e Pescas, Av. Arriaga, 21 Edifício Golden, 3° Andar, 9000-690, Funchal, Portugal
| | - Joachim Blocher
- Institute for Acute Neurology and Stroke, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Luís Cardoso
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801, Vila Real, Portugal
| | - José Manuel Correia da Costa
- Center for Parasite Biology and Immunology, National Institute of Health Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055, Porto, Portugal.,Center for the Study of Animal Science (CECA), Institute for Agricultural and Agro-Alimentary Science and Technology (ICETA), University of Porto, Porto, Portugal
| | - Pierre Dorny
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Jacinto Gomes
- National Institute for Agrarian and Veterinary Research, Oeiras, Portugal
| | | | - Pikka Jokelainen
- Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014, Helsinki, Finland.,Laboratory of Parasitology, Department of Bacteria, Fungi & Parasites, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark.,Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Kreutzwaldi 62, 51014, Tartu, Estonia
| | - Miriam Kaminski
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Brane Krt
- Institute for Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000, Ljubljana, Slovenia
| | - Pascal Magnussen
- Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.,Department of Veterinary and Animal Sciences, section for Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lucy J Robertson
- Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, 0033, Oslo, Norway
| | - Veronika Schmidt
- Centre for Global Health, Department of Neurology, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany.,Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - Erich Schmutzhard
- Department of Neurology, NICU Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - G Suzanne A Smit
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Barbara Šoba
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Christen Rune Stensvold
- Laboratory of Parasitology, Department of Bacteria, Fungi & Parasites, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark
| | - Jože Starič
- Clinic for reproduction and large animals - section for ruminants, Veterinary faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Karin Troell
- National Veterinary Institute, SE-751 89, Uppsala, Sweden
| | - Aleksandra Vergles Rataj
- Institute for Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000, Ljubljana, Slovenia
| | - Madalena Vieira-Pinto
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801, Vila Real, Portugal.,CECAV - Animal and Veterinary Research Centre, UTAD, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - Manuela Vilhena
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM), Universidade de Évora, Évora, Portugal
| | - Nicola Ann Wardrop
- Geography and Environment, University of Southampton, Highfield Campus, Southampton, England, SO17 1BJ, UK
| | - Andrea S Winkler
- Centre for Global Health, Department of Neurology, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany.,Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Purification and kinetic analysis of cytosolic and mitochondrial thioredoxin glutathione reductase extracted from Taenia solium cysticerci. Exp Parasitol 2015; 149:65-73. [DOI: 10.1016/j.exppara.2014.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/10/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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Bae YA, Xue Y, Lee EG, Kim SH, Kong Y. Bioactive molecules ofTaenia soliummetacestode, a causative agent of neurocysticercosis. Expert Rev Proteomics 2014; 7:691-707. [DOI: 10.1586/epr.10.72] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Central nervous system (CNS) infections—i.e., infections involving the brain (cerebrum and cerebellum), spinal cord, optic nerves, and their covering membranes—are medical emergencies that are associated with substantial morbidity, mortality, or long-term sequelae that may have catastrophic implications for the quality of life of affected individuals. Acute CNS infections that warrant neurointensive care (ICU) admission fall broadly into three categories—meningitis, encephalitis, and abscesses—and generally result from blood-borne spread of the respective microorganisms. Other causes of CNS infections include head trauma resulting in fractures at the base of the skull or the cribriform plate that can lead to an opening between the CNS and the sinuses, mastoid, the middle ear, or the nasopharynx. Extrinsic contamination of the CNS can occur intraoperatively during neurosurgical procedures. Also, implanted medical devices or adjunct hardware (e.g., shunts, ventriculostomies, or external drainage tubes) and congenital malformations (e.g., spina bifida or sinus tracts) can become colonized and serve as sources or foci of infection. Viruses, such as rabies, herpes simplex virus, or polioviruses, can spread to the CNS via intraneural pathways resulting in encephalitis. If infection occurs at sites (e.g., middle ear or mastoid) contiguous with the CNS, infection may spread directly into the CNS causing brain abscesses; alternatively, the organism may reach the CNS indirectly via venous drainage or the sheaths of cranial and spinal nerves. Abscesses also may become localized in the subdural or epidural spaces. Meningitis results if bacteria spread directly from an abscess to the subarachnoid space. CNS abscesses may be a result of pyogenic meningitis or from septic emboli associated with endocarditis, lung abscess, or other serious purulent infections. Breaches of the blood–brain barrier (BBB) can result in CNS infections. Causes of such breaches include damage (e.g., microhemorrhage or necrosis of surrounding tissue) to the BBB; mechanical obstruction of microvessels by parasitized red blood cells, leukocytes, or platelets; overproduction of cytokines that degrade tight junction proteins; or microbe-specific interactions with the BBB that facilitate transcellular passage of the microorganism. The microorganisms that cause CNS infections include a wide range of bacteria, mycobacteria, yeasts, fungi, viruses, spirochaetes (e.g., neurosyphilis), and parasites (e.g., cerebral malaria and strongyloidiasis). The clinical picture of the various infections can be nonspecific or characterized by distinct, recognizable clinical syndromes. At some juncture, individuals with severe acute CNS infections require critical care management that warrants neuro-ICU admission. The implications for CNS infections are serious and complex and include the increased human and material resources necessary to manage very sick patients, the difficulties in triaging patients with vague or mild symptoms, and ascertaining the precise cause and degree of CNS involvement at the time of admission to the neuro-ICU. This chapter addresses a wide range of severe CNS infections that are better managed in the neuro-ICU. Topics covered include the medical epidemiology of the respective CNS infection; discussions of the relevant neuroanatomy and blood supply (essential for understanding the pathogenesis of CNS infections) and pathophysiology; symptoms and signs; diagnostic procedures, including essential neuroimaging studies; therapeutic options, including empirical therapy where indicated; and the perennial issue of the utility and effectiveness of steroid therapy for certain CNS infections. Finally, therapeutic options and alternatives are discussed, including the choices of antimicrobial agents best able to cross the BBB, supportive therapy, and prognosis.
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Affiliation(s)
- A Joseph Layon
- Pulmonary and Critical Care Medicine, Geisinger Health System, Danville, Pennsylvania USA
| | - Andrea Gabrielli
- Departments of Anesthesiology & Surgery, University of Florida College of Medicine, Gainesville, Florida USA
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Influence of gender on cardiac and encephalic inflammation in the elderly with cysticercosis: a case control study. J Trop Med 2012; 2012:540858. [PMID: 23056059 PMCID: PMC3463955 DOI: 10.1155/2012/540858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/24/2012] [Accepted: 08/15/2012] [Indexed: 11/18/2022] Open
Abstract
Background. The present study explores the influence of the host's age and gender upon the inflammatory infiltrate. We aimed to quantify the inflammatory infiltrate caused by cysticercosis, which is related to aging, in the heart and in the encephalon. Methods. 75 autopsy protocols with cysticercosis diagnosis from department of pathology at a university hospital from 1970 to 2008 were reviewed. Two groups were formed: elderly with cysticercosis and nonelderly with cysticercosis. We used KS-300 (Kontron-Zeiss) software for morphometric analysis of the inflammation. Results. The elderly had an average of 3.1 ± 2.5 cysticerci, whereas the non-elderly had 2.7 ± 3.8 parasites. The non-elderly group with cysticercosis had significantly more inflammation, both cardiac and encephalic, than the elderly group. The elderly females with cysticercosis had more cardiac and encephalic inflammation. Conclusions. In this study, we showed that the non-elderly had significantly more cardiac and encephalic inflammation than the elderly, and that such inflammatory infiltrate decreases with age and depends upon the evolutionary stage of the cysticercus. Furthermore, there are differences concerning gender in the intensity of the inflammatory response due to cysticerci in the heart and brain parenchyma during senescence. Even during this period, women continue to have a more intense response to the parasitosis.
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Rodriquez RD, Crestani DNDS, Soares JOD, Franceshini PR, Alves RP, Zimerman R, Ferreira N, Barea LM. Bruns' syndrome and racemose neurocysticercosis: a case report. Rev Soc Bras Med Trop 2012; 45:269-71. [DOI: 10.1590/s0037-86822012000200027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 02/01/2011] [Indexed: 11/22/2022] Open
Abstract
Cysticercosis is an infection caused by the larval stage of the tapeworm Taenia solium. The parasite may infect the central nervous system, causing neurocysticercosis (NCC). The clinical manifestations depend on load, type, size, location, stage of development of the cysticerci, and the host's immune response against the parasite. The racemose variety occurs in the ventricles or basal cisterns and is a malignant form. Mobile ventricular mass can produce episodic hydrocephalus on changing head posture with attacks of headache, vomiting, and vertigo, triggered by abrupt movement of the head, a phenomenon called Bruns' syndrome (BS). We report a patient with racemose NCC and BS.
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Abstract
INTRODUCTION Cysticercosis (CC) is the most important of the parasitic diseases of the central nervous system due to its high incidence in the world. CC is the infection with the larval cysts of Taenia solium. It is the most common helminthic infection of the nervous system and is endemic in most underdeveloped countries as well as in industrialized nations. It is estimated that approximately 50,000 people die every year from neurocysticercosis (NCC) worldwide. DISCUSSION Humans with CC are incidental intermediate hosts, which replace the pig in the life cycle of the T. solium. Children are more frequently affected by parenchyma infestation of cysticercus, of which the main clinical manifestation is epilepsy. Hydrocephalus is more common in adults and is caused by cerebrospinal fluid blockage by ventricular cysts and inflammatory reactions (ependimitis/arachnoiditis). Treatment should be individualized based on clinical presentation, degree of infestation, location and viability of cysticercus, and host response. Hydrocephalus can be controlled only by removal of obstructive intraventricular cysts or associated with either ventriculoperitoneal shunt or endoscopic third ventriculostomy. The degree of infestation and complications related to the shunt represents the most important prognostic factors in the outcome of NCC.
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Bhattarai R, Budke CM, Carabin H, Proaño JV, Flores-Rivera J, Corona T, Cowan LD, Ivanek R, Snowden KF, Flisser A. Quality of life in patients with neurocysticercosis in Mexico. Am J Trop Med Hyg 2011; 84:782-6. [PMID: 21540389 DOI: 10.4269/ajtmh.2011.10-0646] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The objective of this study was to compare quality of life measures in patients with neurocysticercosis (NCC) to those of a matched control group. The NCC outpatients and their controls were recruited from two neurology referral hospitals in Mexico City, Mexico during 2007-2008. The quality of life of 224 NCC patients was compared with 224 age-sex-hospital-day matched controls using the short form 12 v2 (SF-12 v2) quality of life survey. Medical chart reviews were also conducted for the NCC outpatients to evaluate presenting clinical manifestations. Compared with the controls, NCC patients had a significantly lower score for each of the eight domains of health evaluated and significantly lower Physical and Mental Component Summary scores. Chart reviews indicated that hydrocephalus (48%), severe headaches (47%), and epilepsy (31%) were the most common clinical manifestations in these NCC outpatients.
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Affiliation(s)
- Rachana Bhattarai
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
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Park SY, Kong MH, Kim JH, Song KY. Disseminated cysticercosis. J Korean Neurosurg Soc 2011; 49:190-3. [PMID: 21556243 DOI: 10.3340/jkns.2011.49.3.190] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 07/02/2010] [Accepted: 02/06/2011] [Indexed: 11/27/2022] Open
Abstract
Disseminated cysticercosis is a rare form of cysticercosis in which the cysticerci spread out through the whole body. We report the first case of a 39-year-old Mongolian with disseminated cysticercosis. He visited our hospital with generalized tonic-clonic seizure. After extensive investigation from brain computed tomography (CT), spine magnetic resonance imaging (MRI), whole body MRI and pathologic biopsy, he was diagnosed as having cysticercosis involving the brain, subcutaneous tissue, and skeletal muscles through the whole body. We treated him with the albendazole in which case the followed MRI showed that numbers of cystic lesions were copiously decreased. We report an unsual case of disseminated cysticercosis treated with medical therapy.
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Affiliation(s)
- Soo Yong Park
- Department of Neurosurgery, Seoul Medical Center, Seoul, Korea
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12
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Gonçalves FDA, Machado GA, Oliveira HB, Rezende MTNP, Mineo JR, Costa-Cruz JM. Hydrophobic fraction of Taenia saginata metacestodes, rather than hydrophilic fraction, contains immunodominant markers for diagnosing human neurocysticercosis. Rev Soc Bras Med Trop 2011; 43:254-9. [PMID: 20563491 DOI: 10.1590/s0037-86822010000300008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 03/12/2010] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Considering that alternative antigens for diagnosing neurocysticercosis continue to be a challenge because of the increasing difficulty in obtaining parasites from naturally infected pigs for preparation of Taenia solium homologous antigen, the aim of the present study was to evaluate the detergent (D) and aqueous (A) fractions from saline extract of Taenia saginata metacestodes for diagnosing neurocysticercosis. METHODS Taenia saginata was obtained from naturally infected bovines in the Triângulo Mineiro region, State of Minas Gerais, Brazil. The carcasses came from cold storage units and had been slaughtered in accordance with the inspection technique recommended by the Federal Inspection Service. The D and A fractions were obtained by using Triton X-114 (TX-114). Serum samples were obtained from 40 patients with a diagnosis of neurocysticercosis, 45 with other parasitic diseases and 30 from apparently normal individuals. IgG antibody levels were evaluated using the ELISA and immunoblotting assays. RESULTS The ELISA sensitivity and specificity were 95% and 73.3%, when using saline extract; 95% and 82.6% for the D fraction; and 65% and 61.3% for the A fraction, respectively. The immunoblotting assay confirmed the ELISA results, such that the D fraction was more efficient than the other extracts, and the 70-68 kDa component was immunodominant among neurocysticercosis patients. CONCLUSIONS These results demonstrated that the D fraction from Taenia saginata metacestodes obtained using TX-114 can be used as a heterologous antigenic fraction in the immunoblotting assay for serologically diagnosing human neurocysticercosis, given its ability to select immunodominant antigens.
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Affiliation(s)
- Flávia de Assunção Gonçalves
- Department of Immunology, Microbiology and Parasitology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Lipid peroxidation in the cerebrospinal fluid of patients with neurocysticercosis. Trans R Soc Trop Med Hyg 2008; 102:1025-31. [DOI: 10.1016/j.trstmh.2008.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Revised: 06/06/2008] [Accepted: 06/06/2008] [Indexed: 12/26/2022] Open
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Sáenz B, Ramírez J, Aluja A, Escobar A, Fragoso G, Morales J, Pérez-Tamayo R, Rosetti F, Larralde C, Sciutto E, Fleury A. Human and porcine neurocysticercosis: differences in the distribution and developmental stages of cysticerci. Trop Med Int Health 2008; 13:697-702. [DOI: 10.1111/j.1365-3156.2008.02059.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Husain M, Rastogi M, Jha DK, Husain N, Gupta RK. ENDOSCOPIC TRANSAQUEDUCTAL REMOVAL OF FOURTH VENTRICULAR NEUROCYSTICERCOSIS WITH AN ANGIOGRAPHIC CATHETER. Oper Neurosurg (Hagerstown) 2007; 60:249-53; discussion 254. [PMID: 17415160 DOI: 10.1227/01.neu.0000255382.72593.81] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Fourth ventricular neurocysticercosis (FVNCC) usually presents with obstructive hydrocephalus. Available treatment options are medical, external cerebrospinal fluid diversion, microsurgical, or endoscopic removal alone or in combination. We present our experience of transaqueductal removal of FVNCC by angiographic catheter with endoscopic third ventriculostomy with a rigid endoscope. METHODS Ten patients (five male and five female patients; age range, 12-45 yr; mean, 23.2 years) with FVNCC with obstructive hydrocephalus underwent endoscopic removal along with endoscopic third ventriculostomy in a single sitting, through a frontal precoronal burr hole. Diagnosis was established on imaging and confirmed on histology in all of the cases. The Gaab Universal Endoscope System along with 4-mm, 30-degree rigid telescopes was used to enter the third ventricle, and a cut length of angiographic catheter was negotiated through the aqueduct for removal of FVNCC. RESULTS Removal of the cyst was performed in all cases. A 30-degree rigid telescope provided excellent image quality, with the ability to address intra-FVNCC through the dilated aqueduct with a curved-tip catheter. None of these patients required any further surgery. There were no significant operative or postoperative complications in any of the cases. All of the patients were asymptomatic, with an average follow-up of 18 months. CONCLUSION Transaqueductal removal of an intra-fourth ventricular cyst along with endoscopic third ventriculostomy with a rigid endoscope and catheter is an effective treatment and obviates the need for posterior cranial fossa exploration.
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Affiliation(s)
- Mazhar Husain
- Department of Neurosurgery, King George's Medical University, Lucknow, India.
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Husain M, Jha DK, Rastogi M, Husain N, Gupta RK. Neuro-endoscopic management of intraventricular neurocysticercosis (NCC). Acta Neurochir (Wien) 2007; 149:341-6. [PMID: 17342378 DOI: 10.1007/s00701-006-1059-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Accepted: 10/05/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC. METHODS Twenty-one cases, 13 females and 8 males (age range 12-50 years; mean, 25.7 years), of intraventricular NCC [lateral (n = 6), third (n = 6), fourth (n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0 degrees and 30 degrees rigid telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular (n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months. RESULTS Complete (n = 18) or partial (n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm rigid telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC. CONCLUSION Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients.
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Affiliation(s)
- M Husain
- Department of Neurosurgery, King George's Medical University, Lucknow, India.
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17
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Delgado-Azañero WA, Mosqueda-Taylor A, Carlos-Bregni R, Del Muro-Delgado R, Díaz-Franco MA, Contreras-Vidaurre E. Oral cysticercosis: a collaborative study of 16 cases. ACTA ACUST UNITED AC 2006; 103:528-33. [PMID: 17395067 DOI: 10.1016/j.tripleo.2006.01.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2005] [Revised: 12/09/2005] [Accepted: 01/24/2006] [Indexed: 11/27/2022]
Abstract
Cysticercosis is a potentially fatal parasitic disease that rarely involves the oral region in humans. This study includes 21 lesions seen in 16 Latin American patients. There were 8 men and 8 women, with an age range from 6 to 67 years (mean 33.6 years). Most cases appeared as asymptomatic submucosal nodules that resembled mucous cysts or benign mesenchymal neoplasms. Most were found in the tongue (11 cases), followed by buccal mucosa and the lower lip (4 cases each) and upper lip (2 cases). These were well circumscribed, and ranged in size from 1 to 2.5 cm in diameter. Typical histologic features of viable cysticerci were observed in 15 cases, and the presence of colloid degeneration and granular mineralization were detected in only 1 case. In all cases, simple surgical excision was sufficient to ensure complete removal of the lesions without postoperative complications. It is important to carry out a detailed study in every case, in order to exclude the presence of the parasite in other sites.
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Affiliation(s)
- Wilson A Delgado-Azañero
- Oral and Maxillofacial Pathology and Medicine Unite, Universidad Peruana Cayetano Heredia, Lima, Peru
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18
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Abstract
BACKGROUND AND PURPOSE Hydrocephalus is a frequent and potentially serious complication of neurocysticercosis. Its treatment often requires ventricular shunting. The complication rate is high due to obstruction or material infection, which may justify endoscopic third ventriculostomy (ETV). OBSERVATION We report a case of obstructive hydrocephalus in a 46-year-old man in the context of racemose cysticercosis, presenting with headaches and transient disorders of consciousness. Imaging showed cystic lesions of the cisterna magna, responsible for hydrocephalus which was treated effectively by ETV. Treatment with albendazole decreased the volume of the cisterna magna cysts. RESULTS The patient was followed for 6 years after ETV with no recurrence of hydrocephalus despite two more symptomatic episodes of the disease with extension of the cysts into the lumen of the fourth ventricle and into the perispinal subarachnoid spaces, effectively treated by albendazole each time. CONCLUSIONS Treatment of obstructive hydrocephalus secondary to cerebral racemose cysticercosis by ETV seems to be an effective and safety technique. The role of ETV should be evaluated in this indication.
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Affiliation(s)
- B Lapergue
- Department of Neurology, Hôpital Henri-Mondor, Créteil
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19
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Arruda GC, da Silva ADT, Quagliato EMAB, Maretti MA, Rossi CL. Evaluation of Taenia solium and Taenia crassiceps cysticercal antigens for the serodiagnosis of neurocysticercosis. Trop Med Int Health 2005; 10:1005-12. [PMID: 16185235 DOI: 10.1111/j.1365-3156.2005.01480.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We evaluated the usefulness of seven cysticercal antigen extracts, four from Taenia solium cysticerci (whole parasite-TsoW, membrane-TsoMe, vesicular fluid-TsoVF and scolex-TsoSc) and three from T. crassiceps cysticerci (whole parasite-TcraW, membrane-TcraMe and vesicular fluid-TcraVF), for serodiagnosis of neurocysticercosis with an enzyme-linked immunosorbent assay (ELISA). Cysticercus-specific IgG were screened in serum samples from 23 patients with neurocysticercosis, 32 patients with other infections and 48 healthy persons. The best results were obtained with the TsoVF-ELISA (91.3% sensitivity; 96.2% specificity) and TcraVF-ELISA (91.3% sensitivity; 95% specificity). The ELISA done with whole parasite and membrane extracts from cysts of T. solium and T. crassiceps and the scolex extract from T. solium cysts showed a low performance in terms of sensitivity, ranging from 47.8% to 73.9%. None of the antigen preparations from T. solium and T. crassiceps cysticerci used in this study showed outstanding performance for the serodiagnosis of neurocysticercosis. However, considering the results obtained with the seven antigen preparations, vesicular fluid from T. solium and T. crassiceps cysticerci may be useful for detecting specific antibodies in sera from patients with neurocysticercosis.
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Affiliation(s)
- G C Arruda
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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20
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Uddin J, Garcia HH, Gilman RH, Gonzalez AE, Friedland JS. Monocyte-astrocyte networks and the regulation of chemokine secretion in neurocysticercosis. THE JOURNAL OF IMMUNOLOGY 2005; 175:3273-81. [PMID: 16116219 DOI: 10.4049/jimmunol.175.5.3273] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neurocysticercosis, caused by infection with larval Taenia solium, is a major cause of epilepsy worldwide. Larval degeneration, which is symptomatic, results in inflammatory cell influx. Astrocytes, the most abundant cell type and major cytokine-producing cell within the CNS, may be important in orchestrating inflammatory responses after larval degeneration. We investigated the effects of direct stimulation and of conditioned medium from T. solium larval Ag (TsAg)-stimulated monocytes (CoMTsAg) on neutrophil and astrocyte chemokine release. CoMTsAg, but not control conditioned medium, stimulated astrocyte CCL2/MCP-1 (161.5 +/- 16 ng/ml), CXCL8/IL-8 (416 +/- 6.2 ng/ml), and CXCL10/IFN-gamma-inducible protein (9.07 +/- 0.6 ng/ml) secretion after 24 h, whereas direct astrocyte or neutrophil stimulation with TsAg had no effect. There was rapid accumulation of CCL2 and CXCL8 mRNA within 1 h, with somewhat delayed expression of CXCL10 mRNA initially detected 8 h poststimulation. Neutralizing anti-TNF-alpha inhibited CoMTsAg-induced CCL2 mRNA accumulation by up to 99%, causing total abolition of CXCL10 and up to 77% reduction in CXCL8 mRNA. CoMTsAg induced maximal nuclear binding of NF-kappaB p65 and p50 by 1 h, with IkappaBalpha and IkappaBbeta decay within 15 min. In addition, CoMTsAg induced transient nuclear binding of AP-1, which peaked 4 h poststimulation. In NF-kappaB blocking experiments using pyrrolidine dithiocarbamate, CoMTsAg-induced CCL2 secretion was reduced by up to 80% (p = 0.0006), whereas CXCL8 was inhibited by up to 75% (p = 0.0003). In summary, the data show that astrocytes are an important source of chemokines following larval Ag stimulation. Such chemokine secretion is NF-kappaB dependent, likely to involve AP-1, and is regulated in a paracrine loop by monocyte-derived TNF-alpha.
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Affiliation(s)
- Jasim Uddin
- Department of Infectious Diseases, Faculty of Medicine and Wellcome Trust Centre for Clinical Tropical Medicine, Imperial College (Hammersmith Campus), London, United Kingdom
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21
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Fleury A, Hernández M, Fragoso G, Parkhouse RME, Harrison LJS, Sciutto E. Detection of secreted cysticercal antigen: a useful tool in the diagnosis of inflammatory neurocysticercosis. Trans R Soc Trop Med Hyg 2004; 97:542-6. [PMID: 15307421 DOI: 10.1016/s0035-9203(03)80019-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neurocysticercosis is a common parasitic disease of the human central nervous system. It is particularly prevalent in developing countries, where it has a serious public health and economic impact. A major diagnostic problem with neurocysticercosis is its pleomorphic nature. Conventional diagnosis of neurocysticercosis still requires brain-computed tomography and/or magnetic resonance imaging, which are definitive but often prohibitively expensive and inaccessible in endemic areas. Herein, the monoclonal antibody HP10 antigen-trapping enzyme-linked immunosorbent assay, which has been used successfully to detect viable Taenia solium cysticercosis, was evaluated using cerebrospinal fluid (CSF) from Mexican neurocysticercosis patients with various defined pathologies. Sensitivity was higher in cases of inflammatory compared with non-inflammatory disease (94.1% vs. 33.3%) and in cases of multiple- compared with single-cyst cysticercosis (85% vs. 33.3%). Positivity was a strong indicator of active, inflammatory, multiple-cyst neurocysticercosis detecting 100% (15/15) of such cases. The overall specificity, as determined using CSF samples from patients with other neurological symptoms, was 97.7% (42/43). Since the assay only detects viable infection, it is of known value in the follow-up of treated patients to determine whether treatment has been successful. Thus, antigen detection may be of particular value in the assessment of symptomatic patients, who may potentially benefit from rapid treatment.
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Affiliation(s)
- A Fleury
- Instituto Nacional de Neurología y Neurocirugía, México DF, México
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22
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Scotoni AE, Manreza MLG, Guerreiro MM. Recurrence after a first unprovoked cryptogenic/idiopathic seizure in children: a prospective study from São Paulo, Brazil. Epilepsia 2004; 45:166-70. [PMID: 14738424 DOI: 10.1111/j.0013-9580.2004.16503.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the recurrence risk after a first unprovoked seizure in a large population of children and adolescents of a developing country. METHODS This prospective study was conducted at two tertiary hospitals, between September 1989 and August 1998. Children were enrolled if they had a first unprovoked cryptogenic/idiopathic seizure and maximal interval to the enrollment < or =90 days. EEG and computed tomography (CT) were performed in most patients. Potential predictors of recurrence were compared by using the Cox proportional hazards model in univariate and multivariate analyses. Survival analysis was performed by using the Kaplan-Meier curves. RESULTS Two hundred thirteen children were included. Recurrence occurred in 34% of the patients, and mean time for recurrence was 12 months. Statistical analysis showed significance for seizure recurrence only for patients with abnormal EEGs. CT was performed in 182 patients, and abnormalities were found in 9.5%. Small calcifications were the most frequent finding, and this was not a predictor for recurrence. CONCLUSIONS The risk of recurrence after a first unprovoked seizure in children from a developing country is similar to that found in developed countries. An abnormal EEG is a risk factor for seizure recurrence in children with a cryptogenic/idiopathic seizure. Calcifications on CT do not increase the risk of recurrence.
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Affiliation(s)
- Anna E Scotoni
- Department of Neurology, University of Campinas, Campinas, Brazil
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23
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Vega R, Piñero D, Ramanankandrasana B, Dumas M, Bouteille B, Fleury A, Sciutto E, Larralde C, Fragoso G. Population genetic structure of Taenia solium from Madagascar and Mexico: implications for clinical profile diversity and immunological technology. Int J Parasitol 2003; 33:1479-85. [PMID: 14572511 DOI: 10.1016/s0020-7519(03)00206-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Taenia solium is a cestode parasitic of humans and pigs that strongly impacts on public health in developing countries. Its larvae (cysticercus) lodge in the brain, causing neurocysticercosis, and in other tissues, like skeletal muscle and subcutaneous space, causing extraneuronal cysticercosis. Prevalences of these two clinical manifestations vary greatly among continents. Also, neurocysticercosis may be clinically heterogeneous, ranging from asymptomatic forms to severely incapacitating and even fatal presentation. Further, vaccine design and diagnosis technology have met with difficulties in sensitivity, specificity and reproducibility. Parasite diversity underlying clinical heterogeneity and technological difficulties is little explored. Here, T. solium genetic population structure and diversity was studied by way of random amplified polymorphic DNA in individual cysticerci collected from pigs in Madagascar and two regions in Mexico. The amplification profiles of T. solium were also compared with those of the murine cysticercus Taenia crassiceps (ORF strain). We show significant genetic differentiation between Madagascar and Mexico and between regions in Mexico, but less so between cysticerci from different localities in Mexico and none between cysticerci from different tissues from the same pig. We also found restricted genetic variability within populations and gene flow was estimated to be low between populations. Thus, genetic differentiation of T. solium suggests that different evolutionary paths have been taken and provides support for its involvement in the differential tissue distribution of cysticerci and varying degrees of severity of the disease. It may also explain difficulties in the development of vaccines and tools for immunodiagnosis.
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Affiliation(s)
- Rodrigo Vega
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Interior S/N, Ciudad Universitaria, México DF 04510, México.
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24
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Chavarría A, Roger B, Fragoso G, Tapia G, Fleury A, Dumas M, Dessein A, Larralde C, Sciutto E. TH2 profile in asymptomatic Taenia solium human neurocysticercosis. Microbes Infect 2003; 5:1109-15. [PMID: 14554252 DOI: 10.1016/s1286-4579(03)00206-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neurocysticercosis (NC), a parasitic disease caused by Taenia solium, may be either asymptomatic or have mild to severe symptoms due to several factors. In this study, the immunological factors that underlie NC pleomorphism were studied. Ten of the 132 inhabitants of a rural community in Mexico (Tepez) had a computerized tomography (CT) scan compatible with calcified NC, and all were asymptomatic. Their immunological profiles were compared with those of 122 CT scan negative (non-NC) subjects from the same village. NC was associated with a TH2 response (IgG4, IL-4, IL-5, IL-13). Subjects from Tepez had higher levels of specific antibodies (IgG1, IgG2, IgG4, IgE) and specific cell proliferation than subjects from an area with low exposure (Ensenada). This suggests that non-NC subjects from Tepez had been exposed to T. solium and resisted infection in the brain. Distinct immunological profiles in equally exposed individuals differing in outcome of infection support the hypothesis of host-related factors in resistance to and pathogenesis of NC. This is the first study reporting the immunological profile associated with the asymptomatic form of NC.
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Affiliation(s)
- Anahí Chavarría
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, UNAM, AP70228, México D.F. 04510, Mexico
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25
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Sciutto E, Martínez JJ, Huerta M, Avila R, Fragoso G, Villalobos N, de Aluja A, Larralde C. Familial clustering of Taenia solium cysticercosis in the rural pigs of Mexico: hints of genetic determinants in innate and acquired resistance to infection. Vet Parasitol 2003; 116:223-9. [PMID: 14559165 DOI: 10.1016/j.vetpar.2003.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In two rural villages of the state of Puebla, Mexico, where Taenia solium pig cysticercosis is highly endemic, 120 pairs of young out-bred piglets were used to assay what proved to be an effective synthetic peptide vaccine against naturally acquired cysticercosis. Because the piglets used were all sired by one of three distinct studs in many different out-bred sows, the prevalence and intensity of infection, as well as degree of protection conferred by the vaccine, could be related to each of the three stud families (A-C). The highest prevalence was found in the C family (25%), whilst the prevalence of B and A families were 21.6 and 4.4%, respectively. Familial clustering of cases was even more conspicuous in vaccinated pigs than in not-vaccinated ones: seven of the nine cysticercosis cases that occurred in the vaccinated group belonged to the C family (7/26) and two to the B family (2/23), whilst the vaccine rendered the A family totally resistant (0/71). Parasite numbers were also higher in the C family in both nai;ve and vaccinated pigs. Familial clustering of cases and of large parasite numbers in naive and vaccinated pigs hint to the relevance of their genetic background in their innate and acquired resistance to cysticercosis.
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Affiliation(s)
- E Sciutto
- Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, AP 70228, Mexico, DF 04510, Mexico.
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26
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Zymberg ST, Paiva Neto MA, Gorgulho AAP, Cavalheiro S. Endoscopic approach to fourth ventricle cysticercosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2003; 61:204-7. [PMID: 12806498 DOI: 10.1590/s0004-282x2003000200009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neurocysticercosis is the most frequently observed parasitosis of the central nervous system worldwide. The fourth ventricle is the most frequent site of intraventricular infestation, a location that carries a higher risk for CSF blockage and intracranial hypertension due to CSF blockage. A great number of patients become shunt dependent which carries a poorer prognosis. We report on a case of a patient with symptomatic obstructive hydrocephalus due to cysticercus in the fourth ventricle where an endoscopic approach via a frontal burr hole was performed. Although there is no consensus in the literature for the optimal treatment of this disease, this method seemed adequate for treatment of fourth ventricle cysticercosis in patients with hydrocephalus, aqueductal and foramen of Monro dilatations.
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Affiliation(s)
- Samuel Tau Zymberg
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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27
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Lino Júnior RDS, Ribeiro PM, Antonelli ÉJ, Faleiros ACG, Terra SA, Reis MAD, Teixeira VDPA. Características evolutivas do Cysticercus cellulosae no encéfalo e no coração humanos. Rev Soc Bras Med Trop 2002. [DOI: 10.1590/s0037-86822002000600012] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
O presente estudo teve como objetivos avaliar a prevalência de cisticercose, classificar as etapas evolutivas dos cisticercos encontrados nos encéfalos e corações humanos, diferenciá-las de acordo com os aspectos macro e microscópicos dos processos patológicos gerais e comparar os processos encontrados nos encéfalos e corações. Foram revisados protocolos de autópsias realizadas no Hospital Escola da Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brasil, no período de 1970 a 2000. Verificou-se a prevalência da cisticercose em 71 casos, sendo 18 (25,4%) de cisticercose cardíaca e 53 (74,6%) de encefálica. Foram analisados 19 cisticercos, sendo 9 de encéfalos e 10 de corações. Os cisticercos foram classificados, de acordo com sua fase evolutiva, em etapas: vesicular, vesicular coloidal, granular nodular e nodular calcificada, com similaridade entre os diagnósticos macro e microscópico. Entre os processos patológicos destacaram-se a beta-fibrilose e a fibroelastose endocárdica. Adicionalmente, demonstrou-se que a classificação pode ser aplicada tanto na cisticercose encefálica como na cardíaca.
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28
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Ferreira LS, Li LM, Zanardi VA, Guerreiro MM. Number and viability of parasite influence seizure frequency in children with neurocysticercosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2002; 60:909-11. [PMID: 12563378 DOI: 10.1590/s0004-282x2002000600004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the relationship between CT findings - number and the viability phase of the parasites - and the seizure frequency in children with neurocysticercosis before and short-term after antiepileptic drug (AED) introduction. We only found a significant interaction between stage of parasitic infection and number of lesions on seizure frequency after AED treatment. Patients with more than five lesions on active or transitional stages had higher seizure frequency predicting a worse short-term prognosis.
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Affiliation(s)
- Lisiane S Ferreira
- Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brasil
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29
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Morales J, Velasco T, Tovar V, Fragoso G, Fleury A, Beltrán C, Villalobos N, Aluja A, Rodarte LF, Sciutto E, Larralde C. Castration and pregnancy of rural pigs significantly increase the prevalence of naturally acquired Taenia solium cysticercosis. Vet Parasitol 2002; 108:41-8. [PMID: 12191898 DOI: 10.1016/s0304-4017(02)00168-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cuentepec is a rural village of central Mexico, where 1300 pigs were bred at the time of the study in conditions that favor Taenia solium transmission. The tongues of 1087 (84%) of these pigs were visually examined and 33% were found to be cysticercotic. Castration of male pigs increased prevalence from 23 to 50% (P < 0.001) and pregnancy in sows also increased their prevalence from 28 to 59% (P < 0.001). Thus, endocrinological conditions characterized by low levels of androgens or high levels of female hormones probably influence the susceptibility of pigs to T. solium cysticercosis as observed in mice infected with Taenia crassiceps. Delaying castration of male pigs and confinement of sows during pregnancy might significantly decrease the prevalence of pig-cysticercosis and help curb transmission without much cost or difficulty.
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Affiliation(s)
- J Morales
- Universidad Autónoma del Estado de Morelos, Morelos, Cuernavaca, Mexico
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30
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Castellanos-González A, Jiménez L, Landa A. Cloning, production and characterisation of a recombinant Cu/Zn superoxide dismutase from Taenia solium. Int J Parasitol 2002; 32:1175-82. [PMID: 12117500 DOI: 10.1016/s0020-7519(02)00093-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A full-length complementary DNA clone encoding a cytosolic Cu/Zn superoxide dismutase with a M(r) of 15,588 Da was isolated from a Taenia solium larvae complementary DNA library. Comparison analysis of its deduced amino acid sequence revealed a 71% identity with Schistosoma mansoni, 57.2-59.8% with mammalian and less than 54% with other helminth cytosolic Cu/Zn superoxide dismutase. The characteristic motifs and the amino acid residues involved in coordinating copper and zinc enzymatic function are conserved. The T. solium Cu/Zn superoxide dismutase was expressed in the pRSET vector. Enzymatic and filtration chromatographic analysis showed a recombinant enzyme with an activity of 2,941 U/mg protein and a native M(r) of 37 kDa. Inhibition assays using KCN, H(2)O(2), NaN(3) and SDS indicated that Cu/Zn is the metallic cofactor in the enzyme. Thiabendazole (500 microM) and albendazole (300 microM) completely inhibited the activity of T. solium Cu/Zn superoxide dismutase. Thiabendazole had no effect on bovine Cu/Zn superoxide dismutase; in contrast, albendazole had a moderate effect on it at same concentrations. Antibodies against T. solium Cu/Zn superoxide dismutase did not affect the enzymatic function; nevertheless, it cross reacts with several Taenia species, but not with trematodes, nematodes, pig, human and bovine Cu/Zn superoxide dismutase enzymes. Western blot analysis indicated the enzyme was expressed in all stages. These results indicate that T. solium possesses a Cu/Zn superoxide dismutase enzyme that can protect him from oxidant-damage caused by the superoxide anion.
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Affiliation(s)
- Alejandro Castellanos-González
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Edificio A, 2do piso, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico D.F. 04510, Mexico
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31
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Abstract
In the neurosurgical services in many developing countries, treatment of neurocysticercosis (NCC) accounts for greater than 10% of brain surgical procedures and approximately 15% of neurological consultations. In these areas brain cysticercosis is the leading cause of hydrocephalus in adults and the first cause of late-onset epilepsy. During the last two decades, successful medical treatment has been established. Additionally, neuroimaging and immunological studies have clearly defined the topography, pathophysiological mechanisms, and biological status of these lesions. Thus, selection of cases for medical or surgical treatment has improved; in a significant number of cases, both interventions are required. New therapies with either albendazole or praziquantel have respectively reduced to 8 days and to 1 day the course of anticysticidal therapy, which now is fast, effective, inexpensive, atoxic, and convenient, particularly in endemic areas where most patients belong to the lower socioeconomic groups. Additionally, the rational use of steroid agents facilitates the treatment of inflammation, a conspicuous accompaniment in cases of NCC. A major effort, however, is still required to eradicate this disease.
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Affiliation(s)
- Julio Sotelo
- National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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32
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Ferreira LS, Zanardi VA, Li MLI, Guerreiro MM. Interrelationship between radiologic findings and prognosis of epilepsy in children with neurocysticercosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2002; 60:1-5. [PMID: 11965400 DOI: 10.1590/s0004-282x2002000100001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Epileptic manifestations of Neurocysticercosis (NC) appear to depend on number and localization of the cysts. The objective of this study was to investigate the relationship between CT findings, number of parasites and the evolutive stage of the cysts, and the prognosis of epilepsy in children with NC. METHOD We studied 28 patients with the parenchymal form of NC, considering: epilepsy duration; seizure frequency before and after AED treatment; seizure control; number of AED and recurrence after AED withdrawal. Clinical information was crossed with the number of lesions and disease activity in univariate comparison. RESULTS The analysis of the clinical data in relation to the number of lesions and disease activity showed no statistical difference among the variables (p>0.05). CONCLUSION We conclude that the course of epilepsy due to NC in childhood cannot be based exclusively on the number or stage of the parasites.
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Huerta M, de Aluja AS, Fragoso G, Toledo A, Villalobos N, Hernández M, Gevorkian G, Acero G, Díaz A, Alvarez I, Avila R, Beltrán C, Garcia G, Martinez JJ, Larralde C, Sciutto E. Synthetic peptide vaccine against Taenia solium pig cysticercosis: successful vaccination in a controlled field trial in rural Mexico. Vaccine 2001; 20:262-6. [PMID: 11567772 DOI: 10.1016/s0264-410x(01)00249-3] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Taenia solium cysticercosis seriously affects human health when localised in the central nervous system (CNS) and causes great economic loss in pig husbandry in rural areas of endemic countries. Increasing the resistance to the parasite in the obligatory host pig may help in curbing transmission. Three synthetic peptides based on protein sequences of the murine parasite Taenia crassiceps, which had previously been shown to induce protection in mice against homologous challenge, were tested as a vaccine against T. solium cysticercosis in pigs. Vaccinated and unvaccinated piglets (240 in all) were distributed in pairs among the peasants' households of two rural villages in Mexico in which 14% of the native pigs were cysticercotic. Ten to twelve months later, the effect of vaccination was evaluated at necropsy. Vaccination decreased the total number of T. solium cysticerci (98.7%) and reduced the prevalence (52.6%). The natural challenge conditions used in this field trial strengthen the likelihood of successful transmission control to both pig and human through a large-scale pig vaccination program. We believe this is a major contribution in anticysticercosis vaccine development as these rather simple yet protective peptides are potentially more cost-effective to produce and less variable in results than antigens that are more complex.
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Affiliation(s)
- M Huerta
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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Sotelo J, Izurieta M, Arriada N. Treatment of hydrocephalus in adults by placement of an open ventricular shunt. J Neurosurg 2001; 94:873-9. [PMID: 11409513 DOI: 10.3171/jns.2001.94.6.0873] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Ventricular shunt placement is the neurosurgical procedure most frequently associated with complications. Over the years, it has been a growing concern that the performance of most shunting devices does not conform to physiological parameters. An open ventriculoperitoneal (VP) bypass with a peritoneal catheter for which the cross-sectional internal diameter was 0.51 mm as a distinctive element for flow resistance was evaluated for use in the treatment of adult patients with hydrocephalus. METHODS During a 2-year period, open shunts were surgically implanted in 54 adults with hydrocephalus; conventional shunts were implanted in 80 matched controls. Periodic evaluations were performed using neuroimaging studies and measures of clinical status. All patients were followed from 12 to 36 months. 18.5 +/- 4 months for patients with the open shunt and 19.1 +/- 8.1 months for controls (mean +/- standard deviation). The device continued to function in 50 patients with the open shunt (93%) and in 49 controls (61%: p < 0.001). The Evans index in patients with the open shunt was 0.33 +/- 0.09 throughout the follow up. No cases of infection, overdrainage, or slit ventricles were observed: the index in controls was 0.28 +/- 0.08; 60% of them developed slit ventricles. During the follow-up period occlusion occurred in four patients with the open shunt (7%) and in 31 controls (39%: p < 0.001). CONCLUSIONS The daily cerebrospinal fluid (CSF) drainage through the open VP shunt is close to 500 ml of uninterrupted flow propelled by the hydrokinetic force generated by the combination of ventricular pressure and siphoning effect. It complies with hydrokinetic parameters imposed by a bypass connection between the ventricular and peritoneal cavities as well as with the physiological archetype of continuous flow and drainage according to CSF production. The open shunt is simple, inexpensive, and an effective treatment for hydrocephalus in adults.
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Affiliation(s)
- J Sotelo
- Division of Research, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
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Mehandru S, Bini EJ. Small Intestinal Infections. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2001; 4:149-162. [PMID: 11469973 DOI: 10.1007/s11938-001-0027-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The differential diagnosis of small intestinal infections is broad, making the identification and management of these disorders challenging. The majority of cases of acute diarrhea are self-limited and do not require diagnostic evaluation or treatment. Most patients do not require specific therapy, and treatment should focus on fluid and electrolyte replacement. In patients with severe, persistent, or chronic diarrhea, a careful medical history and routine stool testing are helpful in determining the cause. Pathogen-specific therapy should be given in patients in whom a pathogen is identified. In those without an identifiable pathogen, antidiarrheal agents are helpful in reducing the number of bowel movements and preventing further dehydration. Endoscopy may be helpful in patients with severe diarrhea and a negative stool evaluation, particularly in HIV-infected patients with chronic diarrhea. Surgery has a limited role in the management of small intestinal infections, but may be lifesaving in patients with intestinal perforation or small bowel obstruction.
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Affiliation(s)
- Saurabh Mehandru
- Division of Gastroenterology 111D, Veterans Administration New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA.
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Sciutto E, Fragoso G, Fleury A, Laclette JP, Sotelo J, Aluja A, Vargas L, Larralde C. Taenia solium disease in humans and pigs: an ancient parasitosis disease rooted in developing countries and emerging as a major health problem of global dimensions. Microbes Infect 2000; 2:1875-90. [PMID: 11165932 DOI: 10.1016/s1286-4579(00)01336-8] [Citation(s) in RCA: 146] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article reviews current knowledge on human and porcine cysticercosis caused by Taenia solium. It highlights the conditions favorable for its prevalence and transmission, as well as current trends in research on its natural history, epidemiology, immunopathology, diagnosis, treatment and prevention. Our opinions on the most urgent needs for further research are also presented.
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Affiliation(s)
- E Sciutto
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, UNAM, AP70228, D.F. 04510, Mexico.
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