Cerebral Cysticercosis by Taenia Crassiceps in a Domestic Cat

Case-report: Massive infection by Cysticercus longicollis in a captive Lemur catta from Italy

An adult male ring-tailed lemur (Lemur catta) from a biopark of northern Italy was submitted to necropsy. A multi-organ parasitic infection was macroscopically evident. Abundant sero-hemorrhagic fluid with larval parasites was present in all cavities. The microscopic evaluation of parasites and the molecular characterization revealed the presence of Cysticercus longicollis (the larval stage of Taenia crassiceps). Histology of liver, lungs, intestine and urinary bladder revealed several larval parasites surrounded by a severe lymphocytic infiltrate, fibrous tissue and hemorrhages. This is the first report of a ring-tailed lemur with an infection of C. longicollis in Italy. The source of infection is still not known however, the discovery of this parasite in a captive lemur poses more attention on the control of parasitic diseases implementing monitoring tests and biosecurity measures.

Taenia crassiceps Cysticercosis in a Wild Muskrat and a Domestic Dog in the Northeastern United States

Taenia crassiceps is a parasite of wild canids and dogs that serve as definite hosts, harboring the adult cestode, whereas rodents are the intermediate hosts in which the metacestode/cysticercus/larval stage occurs. Fecal-oral transmission ensures the parasite's lifecycle. At times, dogs and humans act as accidental intermediate hosts. Despite the public health concern this parasite warrants, its epidemiology remains unclear. In this report, we document the occurrence of metacestodes of T. crassiceps in a muskrat (Ondatra zibethicus) and a domestic dog from the northeastern United States, a development that necessitates increased awareness and surveillance to tackle this disease of "one health" significance. Taenia crassiceps cysticercosis was confirmed in an adult male muskrat in February 2018 and in a 4-year-old female spayed Staffordshire Bull Terrier in December 2020. Parasitological and histopathologic examination of both cases revealed cysticerci with the characteristic rostellar hook morphology that aided in Taenia species identification. In the muskrat case specifically, partial sequencing of the mitochondrial cytochrome oxidase gene confirmed the species identity as T. crassiceps. We report T. crassiceps occurrence in a muskrat in New York State for the first time and document a case presentation in a domestic dog from New Jersey that was infected with metacestode stages of this parasite. Given the detection of this parasite in the northeastern United States, T. crassiceps infection, which otherwise is considered a rare disease, should be on the radar of veterinary, medical and wildlife biologists for timely diagnosis and interventions.

Subcutaneous Taenia crassiceps Cysticercosis Mass Excision from an 11-Year-Old Mixed-Breed Dog

An 11 yr old mixed-breed dog presented with a 2 × 3 cm semimovable subcutaneous soft-tissue mass overlying the right hip region that grew to 8 × 5 cm over a 6 mo period. Two separate fine needle aspiration cytology samples showed marked pyogranulomatous inflammation with no cytologically apparent infectious etiology or neoplasia. Computed tomography imaging revealed a well-marginated, heterogeneous, contrast-enhancing soft-tissue mass extending into the adjacent fat, suggestive of neoplasia. A 14G needle biopsy showed similar chronic inflammatory changes without evidence of neoplasia or infectious etiology. Excisional biopsy of the mass was performed, and ex vivo sectioning revealed Taenia crassiceps cysticerci. Histopathology confirmed severe chronic pyogranulomatous cellulitis and myositis with intralesional cysticerci. Anthelmintic treatment was administered postoperatively, and no evidence of local recurrence has been noted as of 6 mo after the operation. To our knowledge, this is the first case report describing the cytological, histological, cross-sectional imaging characteristics and treatment outcome of T crassiceps cysticercosis in a dog.

Cerebral cysticercosis in a wild Bengal tiger (Panthera tigris tigris) in Bhutan: A first report in non-domestic felids

The endangered Bengal tiger (Panthera tigris tigris) is a keystone species playing an essential role in ecology as well as in the social and spiritual lives of the Himalayan people. The latest estimate of the Bengal tiger population in Bhutan accounts for 103 individuals. Infectious organisms, including zoonotic parasites causing high burden in human health, have received little attention as a cause of mortality in tigers. Taeniosis/cysticercosis, caused by the cestode Taenia solium, is considered one of the major neglected tropical diseases in Southeast Asia. We present here a case of neurocysticercosis in a Bengal tiger showing advanced neurological disease outside Thimphu, the capital city of Bhutan. After palliative care, the animal died, and necropsy revealed multiple small cysts in the brain. Here we show the presence of two genetic variants of T. solium in the parasite material collected based on PCR and sequencing of the complete cox1 and cytB genes. The sequences form a discrete branch within the Asia plus Madagascar cluster of the parasite. On other hand, tests for feline morbillivirus, feline calicivirus, canine distemper virus, Nipah, rabies, Japanese encephalitis, feline leukaemia and feline immunodeficiency virus were negative. In contrast, PCR for feline herpesvirus was positive and a latex agglutination test revealed an elevated antibody titer against Toxoplasma gondii (titer 1:256). The molecular examination of taeniid eggs isolated from the tiger faeces produced sequences for which the highest homology in GenBank is between 92% and 94% with T. regis and T. hydatigena. This fatal case of T. solium neurocysticercosis, a disease previously unrecorded in tigers or other non-domestic felids, demonstrates an anthropogenically driven transmission of a deadly pathogen which could become a serious threat to the tiger population.

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This is the first report of a fatal infection with Taenia solium in a Bengal tiger.

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There is a need for research into infectious disease threats to tigers in Bhutan.

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The importance of a ‘One Health’ approach is demonstrated and recommended.

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Non-domestic felids.

Symptomatic lateral ventricular cystic lesion in a young cat

Case summary

A 1.5-year-old male neutered Persian cat was referred for acute deterioration of chronic left head tilt and ataxia. A lateral intraventricular cystic lesion, closely associated with the left choroid plexus, was identified on MRI. The intralesional signal intensity and cytological analysis of the fluid revealed a liquid similar to cerebrospinal fluid. After trepanation, an endoscopic-assisted fenestration and aspiration of the cyst were performed to temporally relieve the high intracranial pressure while waiting for surgical cystoperitoneal shunt placement. Three weeks after surgery, clinical relapse and recurrence of the lesion were noted on the pre-cystoperitoneal shunting MRI. During anaesthesia, the cat arrested. Cardiac resuscitation was successfully performed and cystoperitoneal shunting was postponed. Global brain ischaemia was then suspected, based on major forebrain clinical signs and MRI abnormalities. During a 6-month recovery period, a further three fine-needle CT-guided aspirations of the lesion were required, owing to clinical recurrence and increased cyst size. Cystoperitoneal shunting was eventually performed, allowing persistent reduction of the lesion and long-term improvement of the cat’s neurological status.

Relevance and novel information

This is the first report of a symptomatic lateral intraventricular cystic lesion in a cat. A left lateral intraventricular choroid plexus cyst was suspected based on the MRI features. Our case suggests that endoscopic fenestration and CT-guided aspiration are not adequate treatments for long-term management. Cystoperitoneal shunting may be a safe procedure, allowing significant and stable reduction of the cystic lesion, associated with improvement in the cat’s neurological status by preventing high intracranial pressure.

First report of pulmonary cysticercosis caused by Taenia crassiceps in a Cape fur seal (Arctocephalus pusillus)

The cestode Taenia crassiceps parasitizes in the intestine of domestic and wild carnivores, especially in red foxes. Usually, the metacestode stage, also known as Cysticercus longicollis, is located in muscles, peritoneal and pleural cavity of wild rodents. In this case, larval stages were found in a female Cape fur seal, which lived in a German zoo since June 1998. In January 2019, the animal presented clinical signs in terms of inappetence and reduced mobility and, within a short time, it developed dyspnoea and died. Pathological and parasitological examinations were performed. In a large mass of the right thoracic wall and in nodular lung lesions, metacestodes with numerous protoscoleces were identified. Morphological and molecular analyses led to the diagnosis of a Taenia crassiceps infection. Probably, the urban fox population was the source of infection. Thus, regarding the zoonotic potential of this cestode, a regularly performed parasitological examination of pet dogs is recommended.

Wildlife-transmitted Taenia and Versteria cysticercosis and coenurosis in humans and other primates

Wild mustelids and canids are definitive hosts of Taenia and Versteria spp. while rodents act as natural intermediate hosts. Rarely, larval stages of these parasites can cause serious zoonoses. In Europe, four cases of Taenia martis cysticercosis have been diagnosed in immunocompetent women, and two cases in zoo primates since 2013. In North America, a zoonotic genotype related but distinct from Versteria mustelae has been identified in 2014, which had caused a fatal infection in an orangutan and liver- and disseminated cysticercoses in two severely immune deficient human patients in 2018, respectively. Additionally, we could attribute a historic human case from the USA to this Versteria sp. by reanalysing a published nucleotide sequence. In the last decades, sporadic zoonotic infections by cysticerci of the canid tapeworm Taenia crassiceps have been described (4 in North America, 8 in Europe). Besides, 3 ocular cases from North America and one neural infection from Europe, all in immunocompetent patients, 6 cutaneous infections were described in severely immunocompromised European patients. Correspondingly, besides oral infections with taeniid eggs, accidental subcutaneous oncosphere establishment after egg-contamination of open wounds was suggested, especially in cases with a history of cutaneous injuries at the infection site. Taenia multiceps is mainly transmitted in a domestic cycle. Only five human coenurosis cases are published since 2000. In contrast, T. serialis coenurosis (1 human case since 2000) is primarily transmitted by wild canids. The etiological diagnosis of exotic cysticercoses is challenging. Usually, clinical material does not allow for a morphological identification, and serological tests are not available. These limitations have partly been overcome by molecular tools. Without claiming any dramatic emergence of cysticercoses and coenuroses transmitted by wild carnivores, further sporadic cases of such ‘exotic’ infections have to be expected.

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Wild canids and mustelids transmit rare but potentially fatal cysticercoses and coenuroses.

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Martens and weasels can rarely transmit dangerous parasitic infections.

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Tapeworm eggs may contaminate wounds and develop locally.

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In North America, the mustelid tapeworm Versteria causes severe human infections.

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Molecular analyses from minute clinical material allows for a specific diagnosis.

Model systems for investigating disease processes in neurocysticercosis

Neurocysticercosis (NCC) occurs following brain infection by larvae of the cestode Taenia solium. It is the leading cause of preventable epilepsy worldwide and therefore constitutes a critical health challenge with significant global relevance. Despite this, much is still unknown about many key pathogenic aspects of the disease, including how cerebral infection with T. solium results in the development of seizures. Over the past century, valuable mechanistic insights have been generated using both clinical studies and animal models. In this review, we critically assess model systems for investigating disease processes in NCC. We explore the respective strengths and weaknesses of each model and summarize how they have contributed to current knowledge of the disease. We call for the continued development of animal models of NCC, with a focus on novel strategies for understanding this debilitating but often neglected disorder.

TAENIA CRASSICEPS CYSTICERCOSIS IN A NILGIRI LANGUR ( SEMNOPITHECUS JOHNII)

  A captive-born adult female Nilgiri langur ( Semnopithecus johnii) developed an edematous swelling of the left thigh and a firm mass around the right ankle joint. The animal also suffered from lethargy and anorexia and was euthanized because of poor general condition. Necropsy revealed that the skeletal muscle of the left thigh had been replaced by a multilocular cystic mass containing numerous sand-grain-sized whitish structures. Small cysts were also present in the lung and the myocardium. The mass of the right ankle joint was histologically consistent with a myxosarcoma. In contrast, the cystic masses from the left thigh, the lung, and the myocardium represented metacestode tissue with evidence of numerous larval cestodes consistent with cysticerci. Cysticerci showed morphological characteristics of Cysticercus longicollis, the larval form of Taenia crassiceps, which was confirmed by genetic analysis. This is the first documented case of a Taenia crassiceps cysticercosis in an Old World monkey species.

Fatal pulmonary cysticercosis caused by Cysticercus longicollis in a captive ring-tailed lemur (Lemur catta)

Here we describe fatal pulmonary cysticercosis caused by Cysticercus longicollis, the larval stage of Taenia crassiceps in a 15-year-old female ring-tailed lemur (Lemur catta) from Sarajevo Zoo. After sudden death, the lemur was subjected to necropsy and large multicystic structure, subdivided with fibrous septa and filled with numerous translucent, oval to ellipsoid bladder-like cysts (cysticerci), almost completely replacing right lung lobe was observed. In addition, numerous free and encysted cysticerci were found in the thoracic cavity. Histopathology revealed connective tissue outlined cavities that compress lung parenchyma. Each cavity contained several thin walled cysticerci with single inverted protoscolex, one or more suckers and rostelum with two rows of hooks. In many of the cysticerci one or several exogenous buds of daughter cysticerci were observed. Based on morphology and microscopic appearance the parasite was identified as C. longicollis. Subsequent molecular analysis and sequencing confirmed presumptive diagnosis. To our knowledge, this case represents the first report of T. crassiceps and cysticercosis caused by C. longicollis in Bosnia and Herzegovina.

Abdominal Cysticercosis in a Red Fox ( Vulpes vulpes )

A large abdominal mass containing numerous cysticerci identified as those of Taenia crassiceps (=Cysticercus longicollis) was found in the pelvic region of the abdominal cavity of a severely constipated and emaciated red fox ( Vulpes vulpes ) in Prince Edward Island, Canada. Cysticercosis has not previously been reported in a wild canid in North America.

[Subcutaneous Taenia crassiceps-cysticercosis in a dog with Cushing's syndrome]

A male, 12-year-old Cairn terrier suffering from Cushing's syndrome with two therapy-resistant inflammatory subcutaneous lesions was examined pathomorphologically and parasitologically. Within the subcutaneous tissue, there was a suppurative to necrotizing and histiocytic inflammation present with the formation of caverns. Intralesional whitish-grey cysts with a diameter of 1-4 mm were detected. Molecular investigations of the cysts confirmed the preliminary morphological identification as Cysticercus longicollis. The adenohypophysis showed an infiltrative growing carcinoma. Cysticercus longicollis is the metacestode of Taenia (T.) crassiceps, a tapeworm of foxes and coyotes. Small rodents are typical intermediate hosts, in which the metacestode develops within the body cavities as well as in the subcutis. Subcutaneous cysticercosis after infection with eggs of T. crassiceps is also described in different domestic animal species and in humans, who represent aberrant intermediate hosts. Immunosuppression due to Cushing's syndrome, probably caused by the tumor of the adenohypophysis, may have played a role in the pathogenesis of the present case.

When things go wrong: Cysticercus longicollis in an adult wild red fox (Vulpes vulpes)

First case of Cysticercus longicollis, larval stage of Taenia crassiceps, was diagnosed in a wild adult male red fox (Vulpes vulpes). The fox was killed by dogs at Nature Park Medvednica and presented to the University of Zagreb Faculty of Veterinary Medicine with history of being unable to run away and having skin lesions on legs that resembled to those of mange. Necropsy revealed whitish fluctuant mass full of cysticercus-like structures, surrounded by fibrous capsule and placed between the leg muscles, and numerous of spherical cysts in the subcutis and in the peritoneal cavity. Cysticerci were identified as C. longicollis based on their size, number and size of the rostellar hooks, mode of proliferation and DNA analysis. To our knowledge, this is the first case of T. crassiceps cysticercosis in a wild carnivore.

Management of a chest-wall soft-tissue tumor caused by an infection with the larval tapeworm pathogen Taenia crassiceps

A chest-wall lesion of an immunocompetent patient was initially suspicious for a malignant tumor. Histopathological and polymerase chain reaction examinations revealed an infection with the larval stage of the tapeworm Taenia crassiceps. Curative resection of the tumorous lesion was performed. Treatment options for immunocompromised patients and patients without known immune defect are discussed, because most of the infections occur in immunocompromised individuals.

Generalized Taenia crassiceps cysticercosis in a chinchilla (Chinchilla lanigera)

Taenia crassiceps is a cestode parasite that uses carnivores as definitive hosts and rodents and rabbits as main intermediate hosts, but other animal species and humans may also get infected. One adult male chinchilla (Chinchilla lanigera) from an animal shelter in Switzerland presented widespread subcutaneous fluctuant swellings extended over the forehead, nose, face and thoracic regions with a progressive growth over 3 months. The thoracic swelling was surgically resected, and it consisted of numerous 3-4mm small transparent vesicles, mainly confined to the subcutaneous tissue, which were morphologically identified as cysticerci of T. crassiceps. The diagnosis was confirmed by PCR and DNA sequence analysis of fragments of the mitochondrial small subunit rRNA and NADH dehydrogenase subunit 1 genes. After 1.5 months, due to enlargement of the swollen areas and deterioration of the general health condition, the chinchilla was euthanized and a necropsy was performed. Thousands of small cysticerci were observed widespread in the subcutis, involving underlying musculature of the whole body, in the thoracic cavity, larynx, pharynx and in the retropharyngeal region. Additionally, three larger metacestodes were detected in the liver and morphologically and molecularly identified as Taenia taeniaeformis strobilocerci. The present case represents an indicator of the environmental contamination with Taenia eggs, highlighting the risk of infection for susceptible animals and humans. Besides the clinical relevance for pets, T. crassiceps is a zoonotic parasite and can be also cause of severe cysticercosis in humans.

Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review

Vomiting is a common presenting complaint in feline practice. This article differs from previous reviews in that it is an evidence-based review of the mechanisms, causes, investigation and management of vomiting in the domestic cat. Published evidence was reviewed, and then used to make recommendations for clinical assessment, diagnosis, antiemetic drug treatment, dietary management and monitoring of cats presenting with vomiting. The strength of the evidence on which recommendations are made (and areas where evidence is lacking for cats) has been highlighted throughout.

Other cestodes: sparganosis, coenurosis and Taenia crassiceps cysticercosis

Many cestodes are capable of invading the central nervous system (CNS), and several are highly prevalent in the developing world. Neurocysticercosis due to Taenia solium and echinococcosis due to Echinoccocus granulosus are two of the most common parasitic infections affecting humans, but other less well-known parasites can also infect the nervous system. Coenurosis, caused by Taenia spp. such as T. multiceps, T. serialis, or T. brauni; sparganosis, caused by Spirometra spp., and neurocysticercosis caused by T. crassiceps are three less frequent zoonotic conditions that should be considered in the differential diagnosis of patients presenting with CNS infection - especially if they have lived in or traveled through areas where these infections are endemic. Diagnosis of these infections is typically made through a combination of serological testing, histopathology, and neuroimaging.

Fatty acids oxidation and alternative energy sources detected in Taenia crassiceps cysticerci after host treatment with antihelminthic drugs

Human cysticercosis caused by Taenia crassiceps is rare however it is considered of zoonotic risk. The treatment of the infected patients was successful when using albendazole or praziquantel. The active forms of albendazole inhibit the glucose uptake and the active forms of praziquantel alter glycogen levels and nutrients absorption. The aim of this study was to analyze the production of organic acids that indicate the oxidation of fatty acids and the use of alternative energy sources from T. crassiceps cysticerci removed from the peritoneal cavity of mice treated with low dosages of albendazole (5.75 and 11.5mg/kg) or praziquantel (3.83 and 7.67 mg/kg). The beta-hydroxibutyrate production was higher by the larval stage cysticerci in all treated groups and the propionate production was higher in final stage cysticerci treated with 11.5mg/kg of albendazole when compared to the control group. The larval stages of cysticerci from the groups treated with 5.75 mg/kg of albendazole and 3.83 mg/kg of praziquantel produced more urea than the initial and final stages which indicate amino acids breakdown. We conclude that it was possible to detect the fatty acid oxidation and amino acids breakdown which indicate the use of alternative energy production sources as the used dosages only cause a partial blockage of the glucose uptake and leads to metabolic alterations in the cysticerci. The metabolic behavior observed after host treatment was different from former descriptions of the in vitro one which indicates great host-parasite interaction.

Taenia crassiceps: host treatment alters glycolisis and tricarboxilic acid cycle in cysticerci

Human cysticercosis by Taenia crassiceps is rare although it is considered of zoonotic risk, especially to immunocompromised individuals. Albendazole and praziquantel are widely used and effective in its treatment. Their active forms inhibit the glucose uptake by the parasite and induce muscle contractions that alter its glycogen levels interfering in the energetic metabolism of the parasite and leading to its death. The aim of this study was to evaluate alterations in glycolysis, the tricarboxylic acid cycle and glucose concentrations caused by low dosage treatments of the hosts with albendazole and praziquantel. Therefore, T. crassiceps intraperitoneally infected mice were treated by gavage feeding with 5.75 or 11.5 mg/kg of albendazole and 3.83 or 7.67 mg/kg of praziquantel. The treated mice were euthanized after 24 h and the cysticerci collected were morphologically classified into initial, larval or final phases. Concentrations of the organic acid produced and glucose were evaluated to detect alterations into the glycolysis and the tricarboxylic acid cycle pathways through chromatography and spectrophotometry. The low dosage treatment caused a partial blockage of the glucose uptake by the cysticerci in spite of the non significant difference between its concentrations. An activation of the tricarboxylic acid cycle was noted in the cysticerci that received the treatment due to an increase in the production of citrate, malate and α-ketoglutarate and the consumption of oxaloacetate, succinate and fumarate. The detection of α-ketoglutarate indicates that the cysticerci which were exposed to the drugs after host treatment present different metabolic pathways than the ones previously described after in vitro treatment.

Taenia crassiceps cysticercosis in a ring-tailed lemur (Lemur catta)

Subcutaneous and intraperitoneal cysticercosis due to Taenia crassiceps was diagnosed in a 5-yr-old male ring-tailed lemur (Lemur catta) in the Madrid Zoo-Aquarium (Madrid, Spain). Under laparoscopic examination, several septated fibrous cystic structures and numerous masses of small transparent vesicles (ca. 3 mm in diameter) were observed subcutaneously and inside the peritoneal cavity. Most of the structures were extirpated but, after 2 days of postsurgical intensive care, the animal died. The loss of body weight of the animal after surgical extirpation (566 g) represented 22% of the total weight (body weight before mass removal, 2582 g). The vesicles were identified under light microscopic examination as cysticerci and by molecular diagnosis as Cysticercus longicollis, the larval form of T. crassiceps. The present report represents the first detection of T. crassiceps in the prosimian genus Lemur.

Taenia crassiceps: in vivo and in vitro models

Taenia crassiceps is a cestode parasite of wild and domestic animals that rarely affects humans; it has been widely used as an experimental model. The asexual proliferation by budding is a useful attribute of T. crassiceps cysticerci, which allows the various strains to be maintained indefinitely in the peritoneal cavity of inbred mice. Over the last 50 years, experimental results using larval and adult stages of T. crassiceps have yielded much information on the morphology, infectivity, proliferation dynamics, host immune response, endocrinological responses and vaccine research, all of which have contributed to our knowledge of cestode biology.