About cysticercosis (pork tapeworm infection)

What is cysticercosis (pork tapeworm infection)?

Cysticercosis (pork tapeworm infection) facts

  • Cysticercosis is a parasitic disease caused by ingesting the eggs of the pork tapeworm, Taenia solium.
  • Humans are infected by ingesting raw or undercooked pork, and cysticercosis occurs after the ingestion of Taenia solium eggs.
  • The symptoms of neurocysticercosis may include headaches, confusion, seizures, and vision changes.
  • Cysticercosis is typically diagnosed based on the patient's symptoms and imaging study results. Blood work is sometimes useful.
  • Cysticercosis may be treated with medications, including anthelmintics, corticosteroids, and anticonvulsants, while some patients may require surgery.
  • Cysticercosis can lead to neurologic and ocular complications, and rarely death.
  • Cysticercosis can be prevented by educating individuals about proper food handling, avoidance of raw or undercooked pork, and good personal hygiene.

What is cysticercosis?

Cysticercosis is a systemic parasitic infestation caused by ingesting the eggs of the pork tapeworm, Taenia solium. The symptoms of this illness are caused by the development of characteristic cysts (cysticerci) which most often affect the central nervous system (neurocysticercosis), skeletal muscle, eyes, and skin. Many individuals with cysticercosis never experience any symptoms at all (asymptomatic).

The tapeworm responsible for causing cysticercosis is endemic to many parts of the developing world, including Latin America, Asia, and sub-Saharan Africa. The World Health Organization (WHO) estimates that cysticercosis affects about 50 million people worldwide. The incidence of cysticercosis has increased in the United States due to increased immigration from developing countries. Neurocysticercosis is a leading cause of adult-onset seizures worldwide. The Centers for Disease Control and Prevention (CDC) has designated cysticercosis as one of five "neglected parasitic infections" in the United States, and the WHO has designated cysticercosis as one of 17 "neglected tropical diseases" worldwide.

Historically, the disease has been recognized since about 2000 B.C. by the Egyptians, and later it was described in pigs by Aristotle. The disease was also recognized by Muslim physicians and is thought to be the reason for Islamic dietary prohibition of eating pork. In the 1850s, German investigators described the life cycle of T. solium.

What are the symptoms for cysticercosis (pork tapeworm infection)?

Vasculitis symptom was found in the cysticercosis (pork tapeworm infection) condition

The symptoms will depend on the location and the number of cysticerci, though many individuals with cysticercosis will never develop any symptoms at all. The majority of patients with cysticercosis who present to a health care professional have central nervous system involvement (neurocysticercosis or NCC). Symptoms of neurocysticercosis may include the following:

Involvement of other body tissues may cause skeletal muscle swelling, subcutaneous cysts, and Vision changes from cysts infecting the eyes.

What are the causes for cysticercosis (pork tapeworm infection)?

Cysticercosis in humans is caused by the dissemination in humans of the larval form of the pork tapeworm, Taenia solium, which then form cysts in various organs. When the eggs of Taenia solium are ingested by humans, the tapeworm eggs hatch and the embryos penetrate the intestinal wall and reach the bloodstream. The formation of cysts in different body tissues leads to the development of symptoms, which will vary depending on the location and number of cysts.

What are the treatments for cysticercosis (pork tapeworm infection)?

The treatment of cysticercosis depends on various factors, including the individual's symptoms, the location and number of cysticerci, and the stage of cyst development. Generally speaking, treatment is tailored to each individual patient and their particular presentation, and treatment regimens may include anthelmintic agents, corticosteroids, anticonvulsant medications, and/or surgery. Asymptomatic patients may not require any treatment at all. Controversy does exist as to which patients require treatment with the various medications.

The most commonly used anthelmintic agents include albendazole (Albenza) and less commonly praziquantel (Biltricide). These antiparasitic medications are effective in eliminating viable cysticerci though they may cause reactive localized inflammation. Consequently, the use of these medications must be evaluated on a case-by-case basis. More than one course of treatment may be necessary to completely eliminate active cysts.

Corticosteroids may also be used in conjunction with, or instead of, antiparasitic medications. Corticosteroids are used to decrease inflammation but are not active against the parasite. Again, treatment with these medications must be tailored to each individual case. Consultation with an infectious disease expert is recommended.

Anticonvulsant medications are used in patients with neurocysticercosis experiencing seizures or at high risk for recurrent seizures. Various anticonvulsant medications, such as carbamazepine (Tegretol) or phenytoin (Dilantin), may be prescribed. Consultation with an experienced neurologist may be helpful to determine patient treatment.

Surgical management may also be necessary in select cases of cysticercosis. Surgical removal of central nervous system cysts or placement of a brain shunt (to relieve pressure) is sometimes necessary in some cases of neurocysticercosis. Certain cases of cysticercosis involving the eyes or subcutaneous cysts may also require surgery.

What are the risk factors for cysticercosis (pork tapeworm infection)?

Risk factors associated with acquiring cysticercosis include living in areas where the parasite is endemic (most commonly in rural developing countries where pigs roam freely and come into contact with human feces), drinking water or eating food contaminated with tapeworm eggs, and living in a household where another family member has intestinal tapeworm infection (taeniasis). Individuals who have taeniasis and poor hygiene are also at increased risk of infecting themselves.

Is there a cure/medications for cysticercosis (pork tapeworm infection)?

Taenia Solium or cysticercosis (pork tapeworm infection) is an intestinal infection with adult tapeworms that follows ingestion of contaminated pork. The condition Cysticercosis is a parasitic tissue infection caused by larval cysts of the tapeworm Taenia solium

Diagnosis:

  • Stools are examined under microscope for ova and proglottids.
  • CT and/or MRI and serologic testing for patients with central nervous system symptoms.


Treatments:

  • There are medications available to treat cysticercosis for those who do need treatment. The treatment of cysticercosis may depend on the location of the infection in the body.
  • Some people with cysticercosis do not need to be treated.
     
  • In case of intestinal infections (without neurocysticercosis): Praziquantel or niclosamide (outside the US)
  • For neurocysticercosis: Corticosteroids, antiseizure drugs, and sometimes albendazole or praziquantel.
  • Antiparasitic drugs: Antiparasitic drugs like albendazole, or a combination of albendazole and praziquantel can be prescribed to destroy many parasites and improve outcomes in some cases.
  • Sugery: Sometimes, surgery may be needed. Surgical excision of cysts may be performed in certain cases. Cysticerci affecting the eyes may also be treated surgically.
  • Drain fluid accumulation: Excessive fluid (cerebrospinal fluid) accumulation within the skull (hydrocephalus) may be treated by the insertion of a tube (shunt) to drain excess cerebrospinal fluid (CSF) away from the brain.
  • Antiepileptic drugs (AEDs): Antiepileptic drugs like Phenytoin and carbamazepine are used to treat seizures due to neurocysticercosis.


Conditions
Brain edema,Chronic meningitis,Hydrocephalus,Vasculitis, paralysis,Partial blindness,Seizures,Coma,Death
Drugs
Praziquantel or niclosamide,corticosteroids,Antiseizure drugs,Albendazole or praziquantel,Surgery
Symptoms
Nausea and vomiting, abdominal pain,Headache,Lethargy,Confusion,Vision changes,Balance problems,Weakness or numbness,Seizure

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