Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Objetivo: Las comunicaciones bucosinusales y buco- nasales son condiciones patológicas que se caracterizan por la presencia de una solución de continuidad entre la cavidad bucal y el seno maxilar o la cavidad nasal respectivamente. Una vez que se ha instalado una comunicación es deseable ce- rrar este defecto, evitando así la infección del seno maxilar y posibles dificultades en la deglución, fonación y masticación. Se han propuesto diferentes tratamientos para su resolución, algunos no quirúrgicos y otros quirúrgicos. Los quirúrgicos pueden realizarse desplazando tejidos locales, regionales o injertando. El presente trabajo tiene como objetivo presentar situaciones clínicas de comunicaciones bucosinusales y buco- nasales con diferentes etiologías y sus distintos tratamientos según tamaño y ubicación del defecto. Casos clínicos: Se identificaron pacientes que asistie- ron al Servicio de Cirugía Maxilofacial del Hospital Piñero presentando cuatro comunicaciones bucosinusales agudas y crónicas y una comunicación buconasal crónica. Los casos analizados fueron tratados de manera quirúrgica utilizando di- versos colgajos según tamaño y ubicación del defecto (AU)

Aim: Oroantral and oronasal communications are patho- logical conditions characterized by the presence of a solu- tion of continuity between the oral cavity and the maxillary sinus or nasal cavity respectively. Once a communication has been installed, it is desirable to close this defect, thus avoid- ing infection of the maxillary sinus and possible difficulties in swallowing, phonation, and mastication. Different treatments have been proposed for its resolution, some non-surgical and others surgical. Surgical procedures can be performed by dis- placing local or regional tissue or by grafting. The aim of this case report is to present clinical situations of oral sinus and oral nasal communication with different etiologies and their different treatments according to the size and location of the defect. Clinical cases: A group of patients who attended the Maxillofacial Surgery Service of Piñero Hospital presenting four acute and chronic oral sinus and one oronasal communi- cations were identified. The analyzed cases were treated sur- gically using different flaps according to the size and location of the defect (AU)

Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Resumen Objetivo La cisticercosis es una infección causada por el estado larvario de la tenia del cerdo, Taenia solium. La cavidad bucal es un sitio raro para su localización y representa un desafío diagnóstico para los odontólogos. Se presenta un caso clínico poco frecuente de una cisticercosis lingual en un paciente adulto y su resolución. Caso clínico Paciente de sexo femenino de 23 años de edad, que se presenta ambulatoriamente por una lesión tumoral localizada en el borde lingual del lado derecho, indolora, de crecimiento lento y evolución crónica. Si bien este tipo de tumor es infrecuente, es importante tener conocimiento de su existencia para su correcto diagnóstico clínico, diferencial y su tratamiento.

Abstract Aim Cysticercosis is an infection caused by the larval state of the pig's tapeworm, Taenia solium. The oral cavity is a rare place for its location and represents a diagnostic challenge for dentists. This article presents a rare clinical case of a lingual cysticercosis in an adult patient and its resolution. Clinical case: A 23 -year-old female patient presents as an outpatient due to a tumor lesion located on the right side of the lingual edge, painless, slow-growing and chronic evolution. Although this type of tumor is uncommon, it is important to have knowledge of its existence for its correct clinical, differential diagnosis and treatment.

Vigilancia serológica de la zoonosis parasitaria en 13 regiones de la sierra del Perú: Periodo 2016-2019 / Serological surveillance of parasitic zoonoses in 13 highlands regions of Peru: Period 2016-2019

RESUMEN Objetivos. Determinar la seropositividad a anticuerpos anti-IgG por infección de Echinococcus granulosus, Fasciola hepatica y cisticerco de Taenia solium y describir las características de los infectados en 13 regiones de la sierra peruana entre 2016 y 2019. Materiales y métodos. Estudio observacional transversal, que analizó 7811 fichas epidemiológicas de la vigilancia basada en laboratorio de las zoonosis parasitarias del periodo 2016-2019. El diagnóstico se realizó mediante la detección de anticuerpos tipo IgG anti E. granulosus, F. hepatica y cisticerco de T. solium utilizando antígenos nativos mediante el ensayo inmunoabsorbente ligado a enzimas (ELISA) e Inmunoblot. La diferencia en la frecuencia de casos de estas zoonosis según características identificadas se realizó mediante la prueba chi-cuadrado de Pearson y prueba exacta de Fisher. Resultados. Se determinó una seropositividad de 7,9% para fascioliasis, 4,9% para equinococosis quística, y 2,3% para cisticerco de T. solium. Estas frecuencias fueron mayores en Cerro de Pasco para equinococosis quística (24,5%), en Ayacucho para cisticerco de T. solium (4,5%) y en Puno para fascioliasis (40,6%). Entre las características sociodemográficas, se encontró una diferencia estadísticamente significativa en la frecuencia de casos para todas las zoonosis según grupo etario, ocupación, y región de residencia. Además, se encontró diferencia con el consumo de verduras en emolientes, y entre las características clínico-epidemiológicas con tener antecedentes familiares de las zoonosis parasitarias. Conclusiones. A partir de las 7811 muestras evaluadas, se encontró que estas zoonosis parasitarias están distribuidas en 13 regiones de la sierra del Perú, ocasionando un problema de salud importante, con frecuencias que varían según diversas características.

ABSTRACT Objectives. To determine seropositivity to anti-IgG antibodies against Echinococcus granulosus, Fasciola hepatica and Taenia solium cysticercus infection and to describe the characteristics of the infected patients in 13 regions of the Peruvian highlands between 2016 and 2019. Materials and methods. Cross-sectional, observational study, in which we analyzed 7811 epidemiological records of laboratory-based surveillance of parasitic zoonoses from 2016 to 2019. Diagnosis was established by detecting IgG type anti-E. granulosus, F. hepatica and T. solium cysticercus antibodies using native antigens by enzyme-linked immunosorbent assay (ELISA) and Immunoblot. We evaluated the difference in the frequency of the cases according to identified characteristics using Pearson's chi-square test and Fisher's exact test. Results. Seropositivity was 7.9% for fascioliasis, 4.9% for cystic echinococcosis, and 2.3% for T. solium cysticercus. These rates were higher in Cerro de Pasco for cystic echinococcosis (24.5%), in Ayacucho for T. solium cysticercus (4.5%) and in Puno for fascioliasis (40.6%). Regarding the sociodemographic characteristics, we found a statistically significant difference in the frequency of cases for all zoonoses according to age group, occupation, and region of residence. We also found a difference with the consumption of vegetables in emollients, and between clinical-epidemiological characteristics and having a family history of parasitic zoonoses. Conclusions. From the 7811 samples, we found that these parasitic zoonoses are distributed in 13 regions of the Peruvian highlands, and represent a major health problem, with frequencies that change according to different characteristics.

Intraocular and neuro-cysticercosis with diffuse stromal choroiditis

Intraocular cysticercosis with central nervous system involvement is not that rare. We report a male child with a right-sided painful blind eye who had intraocular cysticercosis and granuloma in the left frontal lobe of the brain. There was an incidental finding of chronic inflammation in the choroid of that eye supported by histopathology. Immunohistochemistry for T-cells marker and B-cells marker was variable. The patient was treated with antiparasitic, anti-epileptic medications, and oral steroids subsequently.

Uncommon-parasitic-infection-isolated-intramuscular-cysticercosis-a-case-report

Human cysticercosis is caused by cysticercus cellulosae, larvae of a tapeworm, taenia solium. Cysticercois can involve any tissue in the body even it has maximum tendency towards neural tissue. The most common affected sites are central nervous system, subcutaneous tissue, eyes and muscles. An isolated case of intramuscular cysticercosis is a rare presentation. Here we present the case of a 35 year old female with a swelling on the posterolateral aspect of right arm and was diagnosed as myocysticercosis which was abuting to the extensor muscle that is triceps muscle on high resolution ultrasound and ct scan and it was managed by antihelminthic medications followed by surgical excision.

Mielopatía dorsal aguda como presentación atípica de una neurocisticercosis espinal

La neurocisticercosis espinal es una enfermedad infecciosa poco frecuente. Su presentación puede ser extraespinal o intraespinal y la mayoría de casos es de evolución subaguda o crónica. Se presenta el caso de una paciente mujer de 55 años, natural y procedente de Lima, Perú, con cuadro clínico de una paraparesia aguda secundaria a una mielopatía dorsal por lesiones quísticas de cisticercosis espinal. La paciente recibió tratamiento médico y quirúrgico con una evolución clínica y de imágenes favorable. Es importante considerar en nuestro contexto epidemiológico, la cisticercosis espinal como diagnóstico diferencial, ante un cuadro clínico de mielopatía aguda, ya que el adecuado enfoque diagnóstico y tratamiento oportuno de esta rara entidad pueden mejorar el pronóstico de los pacientes.

Spinal neurocysticercosis is an infectious and rare disease. Its presentation can be extraspinal or intraspinal and most cases are of subacute or chronic evolution. We report the case of a 55-year-old female patient from Lima, Peru with a 2-day history of acute paraparesis secondary to dorsal myelopathy due to cystic lesions of spinal cysticercosis. The patient received medical and surgical treatment with a favorable clinical and imaging evolution. In our epidemiological context, it is important to consider a spinal cysticercosis as a differential diagnosis when faced with a clinical picture of acute myelopathy, since the appropriate diagnostic approach and timely treatment of this rare entity can improve the prognosis of patients.

Temporal trends in disease burden of major human parasitic diseases in China from 1990 to 2019 / 中国血吸虫病防治杂志

Objective To analysize the temporal trends in the disease burden of major human parasitic diseases in China from 1990 to 2019, so as to provide the evidence for improving the parasitic disease control strategy in China.. Methods The disability-adjusted life years (DALYs) of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis in China from 1990 to 2019 were captured from the Global Burden of Disease Study 2019 (GBD 2019), and age- and gender-specific DALYs of parasitic diseases were estimated. The temporal trends in DALYs of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis were evaluated in China from 1990 to 2019 using average annual percent change (AAPC) with Joinpoint regression analysis. Results The DALYs were 643 836.42 person-years due to food-borne trematodiases, 156 853.03 person-years due to cysticercosis, 79 764.62 person-years due to schistosomiasis, 70 989.73 person-years due to intestinal nematode infections, 4 258.61 person-years due to echinococcosis and 264.86 person-years due to malaria in China in 2019, respectively. The overall DALYs of six parasitic diseases were higher among men (546 441.93 person-years) than among women (409 525.33 person-years), and were greater among adults at ages of 14 to 65 years (684 780.84 person-years) than among children at 14 years and lower (35 437.38 person-years) and the elderly at ages of 65 years and older (235 749.04 person-years). During the period from 1990 to 2019, food-borne trematodiases were the leading cause of DALYs among the six parasitic diseases, and cysticercosis shifted from the fourth leading cause in 1990 to the second leading cause of DALYs in China in 2019, while intestinal nematode infections shifted from the second leading cause in 1990 to the fourth leading cause of DALYs in 2019. The DALYs of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with the fastest drop seen in DALYs due to malaria (AAPC = −19.6%, P = 0.003), followed by due to intestinal nematode infections (AAPC = −8.2%, P < 0.001) and schistosomiasis (AAPC = −3.1%, P < 0.001), and a slow decline was seen in the DALYs of food-borne trematodiases (AAPC = −1.0%, P < 0.001), while there were no significant decrease in the DALYs of echinococcosis (AAPC = −0.5%, P = 0.264) and the DALYs of cysticercosis appeared a tendency towards a rise (AAPC = 0.7%, P < 0.001). Conclusions The disease burden of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with a high disease burden seen due to food-borne parasitic diseases, no remarkable reduction seen in echinococcosis, and a tendency towards a rise seen in cysticercosis. It is recommended to focus on echinococcosis control, and continue to consolidate the control achievements of other major human parasitic diseases in China; meanwhile, the surveillance and prevention of food-borne parasitic diseases should be reinforced.

Ocular cysticercosis in pediatric patient / Cisticercose ocular em paciente pediátrico

ABSTRACT Ocular cysticercosis is a parasitic infection caused by Taenia solium. Its early diagnosis and treatment decreases the possibility of visual morbidity. It can either compromise the anterior chamber or the posterior segment, which translates into an very variable and interspecific presentation that changes depending on the site of the infection. It is important to report this case due to its low presentation rate and the fact that a high suspicion index is required to make an assertive and timely diagnosis. This is especially important in geographical areas that are endemic to this parasite due to the direct relationship between an early diagnosis and treatment and better visual outcomes. In this case report, we will discuss the multidisciplinary interventions of a pediatric patient in a high complexity hospital.

RESUMO A cisticercose ocular é uma infecção parasitária causada pela Taenia solium. O diagnóstico e tratamento precoces diminuem a possibilidade de morbidade visual. Ela pode comprometer a câmara anterior ou o segmento posterior, o que se traduz em uma apresentação muito variável e interespecífica, que muda dependendo do local da infecção. É importante relatar esse caso devido à sua baixa taxa de apresentação e ao fato de que é necessário um alto índice de suspeita para fazer um diagnóstico assertivo e oportuno. Isso é especialmente importante em áreas geográficas endêmicas para esse parasita, devido à relação direta entre diagnóstico e tratamento precoces e melhores resultados visuais. Neste relato de caso, discutiremos as intervenções multidisciplinares de um paciente pediátrico em um hospital de alta complexidade.

Isolated Solitary Intramuscular Cysticercosis involving lateral chest wall: An uncommon presentation

Cysticercosis is a Parasitic disease caused by the larval form of the pork tapeworm Taenia solium. This disease is a major health concern especially in developing world including India but its incidence is underestimated. Not too many cases of isolated intramuscular cysticercosis have been reported in pediatric population. Here we report a case of 4 years old female child presented with swelling over left lower chest over 3-4 months, diagnosed with intramuscular cysticercosis by ultrasonography.

PREVALENCE OF NEUROCYSTICERCOSIS IN AND AROUND OF RURAL KANCHIPURAM.

Cysticercosis has been reported as the most common illness affecting the central nervous system by cystic stage of Taenia. solium pork tapeworm. It is also referred as food borne zoonotic infection with T.solium larva or cysticercus stage in humans. Cysticercosis which affects central nervous system is called neurocysticercosis (NCC). The clinical manifestation of NCC largely depends on the number, type, size of the cysts, stage of development of cyst and degree of host immune response against the parasite. The present study aimed to assess the burden of Objectives: neurocysticercosis infection by CT imaging and antigen detection by ELISA in the community as well as hospital based patients. Blood samples were collected and antigen detection of cysticercosis by ELISA were done and CT Brain was Methods: done to con?rm the diagnosis of neurocysticercosis among the participants. The overall clinical presentation among Results: 640 subjects showed seizure as the major presentation 446 (69.69%). The overall results of the commercial-Ag-ELISA revealed 61 of 446 sera to be positive for Cysticercus antigen, and thus con?rming 13.68% total prevalence of neurocysticercosis in the study region. High index of exposure to T. solium cysticercosis in the study region of south Indian. An early Conclusion: diagnosis and appropriate treatment management can improve the quality of life of a patient.

Infección experimental cerebral con cisticercosis en ovejas / Experimental brain infection with cysticercosis in sheep

RESUMEN Objetivo . Explorar la viabilidad de desarrollar un modelo de neurocisticercosis (NCC) de oveja mediante infección intracraneal de oncosferas de T. solium. Materiales y métodos. Se realizó un modelo de infección experimental de NCC en ovejas. Se inocularon aproximadamente 10 posoncósferas de T. solium cultivadas previamente por 30 días por vía intracraneal en diez ovejas. Las oncósferas, en 0,1 mL de solución salina fisiológica, se inyectaron en el lóbulo parietal a través de una aguja de calibre 18. Resultados. Después de tres meses, en dos ovejas se encontraron granulomas y en una tercera identificó un quiste de 5 mm de diámetro en el ventrículo lateral derecho y la evaluación histológica confirmó que el quiste corresponde a una larva de T. solium. También se utilizó inmunohistoquímica con anticuerpos monoclonales dirigidos contra componentes de membrana y antígenos excretorios/secretorios del quiste de T. solium para confirmar la etiología de los granulomas encontrados. Uno de ellos mostro reactividad ante los anticuerpos monoclonales utilizados, confirmando así que se trató de un cisticerco. Conclusión. Este experimento es la prueba de concepto de que es posible infectar ovejas con cisticercosis por inoculación intracraneal.

ABSTRACT Objective. To explore the feasibility of developing a sheep model of neurocysticercosis (NCC) by intracranial infection with T. solium oncospheres. Materials and methods. We carried out an experimental infection model of NCC in sheep. Approximately 10 T. solium oncospheres previously cultured for 30 days were inoculated intracranially into ten sheep. The oncospheres, in 0.1 mL of physiological saline, were injected into the parietal lobe through an 18-gauge needle. Results. After three months, granulomas were found in two sheep. In a third sheep we identified a 5 mm diameter cyst in the right lateral ventricle and histological evaluation confirmed that the cyst corresponded to a T. solium larva. Immunohistochemistry with monoclonal antibodies directed against membrane components and excretory/secretory antigens of the T. solium cyst was also used to confirm the etiology of the found granulomas. One of them showed reactivity to the monoclonal antibodies used, thus confirming that it was a cysticercus. Conclusion. This experiment is the proof of concept that it is possible to infect sheep with cysticercosis by intracranial inoculation.

Asymptomatic isolated intramuscular cysticercosis in diabetic patient: a case report

Cysticercosis is an endemic disease in multiple areas of the world, caused by ingestion of embryonated eggs of Taenia solium. We reported a case of a 66-year old diabetic male presenting with decrease of consciousness and “rice grain” calcification in bothhemithorax and neck soft tissue region, without findings of cysticercosis in computed tomography (CT) scan. Cysticercosis most commonly affects the central nervous system, causing neurocysticercosis(NCC), while solitary intramuscular cysticercosis without involvement of the central nervous system is rare. Treatment of cysticercosis is indicated for symptomatic patients, including NCCsurgery is indicated in patients with neurovascular compromise caused by growth of cyst. Recognizing the signs and symptomsof cysticercosis is crucial for diagnosis and treatment in endemic areas where Taenia soliumis prevalent.

Update on the diagnosis and management of neurocysticercosis / Atualização no diagnóstico e manejo da neurocisticercose

ABSTRACT Background: Neurocysticercosis (NCC) is a serious public health problem in several developing countries, including those in Latin America, Asia, and Africa. NCC is considered to be the main cause of late-onset epilepsy in endemic areas. Objective: This review summarizes recent advances in diagnosis and therapy of NCC. Methods: Relevant articles and books were reviewed and used as a source of information for this review. Results: The diagnosis of NCC is based upon neuroimaging studies (MRI and computed tomography) and laboratory analysis of the cerebrospinal fluid (CSF). Praziquantel and albendazole are considered parasiticidal drugs against NCC, but there is an intense debate over the value and safety of these drugs. Conclusion: Given the relative scarcity of clinical trials, more comparative interventional studies, especially randomized controlled trials in long-term clinical evolution, are required in order to clarify the controversy over the validity of parasitic therapy in patients with NCC.

RESUMO Antecedentes: A neurocisticercose (NCC) é grave problema de saúde pública nos países em desenvolvimento, especialmente na América Latina, Ásia e África. A NCC é considerada a principal causa de epilepsia de início tardio nas regiões endêmicas. Objetivo: Este artigo pretende discutir os recentes avanços no diagnóstico e tratamento da NCC. Métodos: Artigos científicos e livros relevantes serviram de fonte de informação para esta revisão. Resultados: O diagnóstico da NCC é fundamentado nos exames de neuroimagem (ressonância magnética e tomografia computadorizada) e do líquido cefalorraquiano (LCR). Atualmente, praziquantel e albendazole são considerados eficazes na terapêutica etiológica da NCC, mas há intenso debate quanto à validade e segurança desses medicamentos. Conclusão: Pela relativa carência de ensaios clínicos, são necessários novos estudos particularmente randomizados, controlados e com análise de desfechos clínicos a longo prazo para o esclarecimento da polêmica envolvendo a validade da terapêutica parasiticida na NCC.

A Rare Case of Peripheral Cysticercosis in a Young Female from South India

Human Cysticercosis, a potentially deadly infestation, is the consequence of ingestion of eggs of Taenia solium. Cysticercosis is the most common parasitic infestation of the Central Nervous System, Muscle and Subcutaneous Tissue. About 54% of the patients present with subcutaneous nodules combined with nervous involvement. Cysticercosis is the most common Parasitic Disease of the Central Nervous System in the world but Cysticercosis cutis has been reported much less frequently(less than 2%). Here we are discussing a case of peripheral cysticercosis for which Surgery was done followed by medical treatment. Our patient came with a swelling on the left forearm near cubital fossa duration progressively increasing in size for the past 4 months. Complaints of pain over the swelling. MRI of the swelling was taken which showed a cystic swelling in the subcutaneous plane with a scolex in situ. After ruling out Neurocysticercosis, patient was taken up for excision of the cyst. Histopathology reported positive for cysticercosis with in situ scolex.Postoperative period uneventful and the patient was given a course of albendazole for two weeks. Majority of the patients will be presenting with Neurological Symptoms as Neurocysticercosis. Albendazole is considered as the treatment of choice in most of the cases and is cost effective. An alternate choice is praziquantel which might be given for some patients. Surgical management is preferred for peripheral cyst which is one of the rarest presentation.

Riesgo y distribución geográfica de neurocisticercosis en Chile según egresos hospitalarios (2002-2019) / Epidemiology of cysticercosis in Chile

BACKGROUND: Neurocysticercosis is the most prevalent parasitic disease of the central nervous system in Chile, where sporadic cases are reported, without information about the epidemiology or distribution of the disease. AIM: To identify the main risk zones for cysticercosis in Chile. MATERIAL AND METHODS: Analysis of hospital discharge databases between 2002 and 2019, available at the website of the Chilean Ministry of Health. Cases with B69 code of the tenth international classification of diseases were identified. RESULTS: In the study period, there were 1752 discharges with the diagnoses of neurocysticercosis, ocular cysticercosis and cysticercosis of other sites. The ages of patients ranged from 0 to 89 years with a clustering between 30 and 59 years. Sixty two percent were males. The zone between the regions of Maule and Araucania concentrated 82% of cases. CONCLUSIONS: We identified the zone with the greatest concentration of cysticercosis in Chile, where preventive strategies should eventually be directed.

Effectiveness of training on Taenia solium taeniasis and cysticercosis control knowledge among medical professionals in disease-elimination pilot areas of Henan Province / 中国血吸虫病防治杂志

Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County, a disease-elimination pilot area of Henan Province, so as to evaluate the effectiveness of the training. Methods Three townships in Fangcheng County were randomly selected as the study townships, including Dushu, Bowang and Yangji townships, while Erlangmiao, Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships. The grassroots medical professionals in the study townships were given once training on T. solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020, while those in the control townships were given no interventions. All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups. The baseline and final assessments of the awareness of T. solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020, and the awareness of T. solium taeniasis and cysticercosis control knowledge was compared between the two groups. Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020, including 474 participants in the intervention group and 189 participants in the control group. Results from the 2016 baseline survey showed that the awareness rate of T. solium taeniasis and cysticercosis control knowledge was 28.83% (47/163) among grassroots medical professionals in Fangcheng County, and there were no significant differences in the awareness between the intervention (32.47%, 25/77) and control groups (25.58%, 22/86) (χ2 = 0.939, P > 0.05), between men (30.50%, 43/141) and women (18.18%, 4/22) (χ2 = 1.406, P > 0.05) or between village- (31.39%, 43/137) and township-level medical professionals (15.38%, 4/26) (χ2 = 2.727, P > 0.05), while significant differences were found in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels (χ2 = 8.190, P < 0.05) and duration of working experiences (χ2 = 12.617, P < 0.05), and the awareness rate of T. solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals (χ2 = 6.768, P < 0.05). Only 5.52% (9/163) of the medical professionals had a history of diagnosis and therapy of T. solium taeniasis or cysticercosis, and only 1.23% (2/163) received training on T. solium taeniasis and cysticercosis control knowledge during the past 5 years. Results from the 2020 questionnaire survey showed a higher awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group (93.55%, 116/124) than in the control group (46.60%, 48/103) (χ2 = 61.845, P < 0.05), and no significant differences were seen in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender, level of medical professionals, duration of working experiences or history of diagnosis/therapy of T. solium taeniasis and cysticercosis in the intervention group (χ2 = 1.089, 0.140, 0.081 and 0.453, all P values > 0.05), while there was a significant difference in the awareness rate among medical professionals with different education levels (χ2 = 36.338, P < 0.05). In addition, the awareness rate of T. solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016. Conclusions In the low-prevalence areas of T. solium taeniasis and cysticercosis, long-term and persistent training may improve the awareness of T. solium taeniasis and cysticercosis control knowledge among grassroots medical professionals, which facilitates the timely identification of T. solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.

Evaluation of efficiency of different anti-cysticercus antibody test kits for serodiagnosis of cysticercosis / 中国血吸虫病防治杂志

Objective To evaluate the diagnostic efficiency of four anti-cysticercus IgG, IgG4 or IgM antibody test kits (enzyme-linked immunosorbent assay, ELISA) by different manufacturers, so as to provide insights into the epidemiological investigation and clinical detection of cysticercosis. Methods Forty serum samples from cerebral cysticercosis patients, 100 serum samples from healthy volunteers, 30 serum samples from paragonimiasis skrjabini patients, 17 serum samples from cystic echinococcosis and 19 serum samples from subcutaneous or cerebral sparganosis patients were collected and detected using anti-cysticercus IgG, IgG4 or IgM antibody test kits (brand A) and the anti-cysticercus IgG antibody test kit (brand B). The sensitivity, specificity and false negative rate of the four kits for detection of cysticercosis were estimated. Results The anti-cysticercus IgG, IgG4 or IgM antibody test kits (brand A) showed 95.00% (38/40), 87.50% (35/40), 7.50% (3/40) sensitivities and 98.00% (98/100), 100.00% (100/100) and 100.00% (100/100) for detection of cysticercosis, while the anti-cysticercus IgG antibody test kit (brand B) presented a 75.00% (30/40) sensitivity and 100.00% (100/100) specificity for detection of cysticercosis. The sensitivity for detection of cysticercosis was significantly higher by the anti-cysticercus IgG antibody test kit (brand A) than by the anti-cysticercus IgG antibody test kit (brand B) (χ2 = 6.28, P < 0.05); however, no significant difference was seen in the specificity by two kits (χ2 = 2.01, P > 0.05). The four ELISA kits showed overall false positive rates of 37.88% (25/66), 22.73% (15/66), 62.12% (41/66) and 15.15% (10/66) for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 37.61, P < 0.05), and the anti-cysticercus IgG antibody test kit (brand A) presented the highest overall false positive rate for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 7.56, P’ < 0.008), while a higher overall false positive rate was seen for detection of paragonimiasis, echinococcosis and sparganosis by the anti-cysticercus IgG antibody test kit (brand A) than by the anti-cysticercus IgG antibody test kit (brand B) (χ2 = 8.75, P’ < 0.008). The four ELISA kits showed false positive rates of 40.00% (12/30), 16.67% (5/30), 76.67% (23/30) and 13.33% (4/30) for detection of paragonimiasis (χ2 = 32.88, P < 0.05) and 21.05% (4/19), 26.32% (5/19), 73.68% (14/19) and 15.79% (3/19) for detection of sparganosis (χ2 = 19.97, P < 0.05), and the highest false positive rates were found by the anti-cysticercus IgM antibody test kit (brand A) for detection of paragonimiasis and sparganosis (all P’ < 0.008). However, the four ELISA kits showed comparable false positive rates of 52.94% (9/17), 29.41% (5/17), 23.53% (4/17) and 17.65% (3/17) for detection of echinococcosis (χ2 = 8.24, P > 0.05). In addition, the anti-cysticercus IgM anti-body test kit (brand A) showed false positive rates of 76.67% (23/30), 23.53% (4/17) and 73.68% (14/19) for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 14.537, P < 0.05), with the lowest false positive rate seen for detection of echinococcosis (χ2 = 14.537, P’ < 0.014), while no significant differences were seen in the false positive rate for detection of paragonimiasis, echinococcosis and sparganosis by other three ELISA kits (all P > 0.05). Conclusions The four anti-cysticercus IgG, IgG4 or IgM antibody test kits exhibit various efficiencies for serodiagnosis of cysticercosis. The anti-cysticercus IgG antibody test kit (brand A) has a high sensitivity for serodiagnosis of cysticercosis; however, it still needs to solve the problems of cross-reaction with other parasitic diseases and stability.

Complejo teniasis/cisticercosis / Teniasis / Cysticercosis complex

RESUMEN La neurocisticercosis, como parte del complejo teniasis/cisticercosis, es la helmintiasis que compromete con mayor frecuencia el sistema nervioso central, particularmente en países en vías de desarrollo, en los cuales su transmisión es endémica. Sus manifestaciones clínicas son variables, de acuerdo con su localización en el sistema nervioso central, y resalta la epilepsia como una de sus principales formas de presentación clínica. Los avances en el uso de métodos diagnósticos inmunológicos, así como las neuroimágenes y la introducción hace dos años de nuevos criterios diagnósticos, han mejorado la certeza diagnóstica. La implementación del tratamiento anticestocida asociado con el uso de corticoides y, en algunos casos particulares, la intervención quirúrgica brindan no solo una opción terapéutica, sino también un mejor pronóstico a los pacientes afectados por esta condición. Hoy el reto se centra en implementar medidas de salud pública sobre en el ciclo biológico del CTC para lograr su erradicación.

SUMMARY Neurocysticercosis, as part of the Teniasis / Cysticercosis complex, is helminthiasis that more frequently involves the central nervous system, particularly in countries undergoing development where its transmission is endemic; its clinical manifestations are variable, according to its location in the central nervous system, highlighting epilepsy as one of its main forms of clinical presentation. Advances in the use of diagnostic methods immunological tests, as well as neuroimaging and the introduction two years ago of new criteria diagnoses have improved the diagnostic certainty, with the implementation of anti-treatment cestocide associated with the use of corticosteroids and, in some particular cases, the intervention surgical treatment provides not only a therapeutic option but also a better prognosis for patients affected by this condition. The challenge today is focused on implementing measures of public health on the biological cycle of the CTC to achieve its eradication.

Neurocisticercosis: lesión única cerebral con serología negativa y confirmación post exéresis. Reporte de caso. / Neurocysticercosis: single brain lesion with negative serology and post exeresis confirmation. Case report

Los diagnósticos diferenciales de una lesión única intraparenquimatosa cerebral con borde en anillo son múltiples, desde un proceso infeccioso parasitario hasta una neoplasia primaria del sistema nervioso, por lo que su manejo puede ser controversial y debe tenerse en cuenta la prevalencia epidemiológica según la situación demográfica donde se presente. De esta manera, presentamos el caso de una paciente adulta joven que ingresó al servicio de neurocirugía con sintomatología focal sensitiva asociado a cefalea intermitente, con una TC de encéfalo que reveló una lesión subcortical localizada en la parte superior del giro postcentral izquierdo con edema perilesional importante y realce periférico tras contraste. Se realizaron pruebas de serología en suero y LCR para neuroparásitos, las cuales se reportaron negativas. Se procedió a realizar exéresis completa de la lesión con uso de ecografía intraoperatoria para minimizar tiempo quirúrgico y área de lesión cortical, la cual se envió a estudio de histopatología y reportó el diagnóstico de neurocisticercosis en estadio nodular granulomatoso. Se realiza el presente reporte de caso con una búsqueda exhaustiva en la literatura sobre la sensibilidad y utilidad de las pruebas de serología parasitaria para la confirmación diagnóstica de la neurocisticercosis y para evitar intervenciones neuroquirúrgicas invasivas

The differential diagnoses of single, ring-enhancing brain lesions are multiple, from a parasitic infection to a primary tumor of the central nervous system, therefore, the management of these lesions can be controversial, and the epidemiological prevalence must be taken into account according the demographic situation of the patient. We present the case of a young adult female who was admitted to the neurosurgery service, debuting sensory focal symptoms associated with headache. Brain CT and MRI revealed a subcortical cyst-like lesion in the left superior postcentral gyrus, with large perilesional edema and peripheral enhancement following contrast administration. Serological test for CNS parasites in serum and CSF were negative. Consequently, we realized a complete removal of the cyst with intraoperative ultrasound to optimize the surgical time and the cortical surgical area. The histopathological examination revealed a degenerating cysticercus. For this reason, a bibliographic research was carried out to identify the sensitivity of serological tests for the diagnostic confirmation of neurocysticercosis and thus avoid invasive neurosurgical interventions

Eficacia de dos formulaciones de oxfendazol producidas localmente para el tratamiento de la cisticercosis en cerdos infectados naturalmente

Se evaluó la eficacia de dos formulaciones de oxfendazol (OFZ) contra cisticercosis producidas localmente, al 22,5% y 10% en comparación con una formulación comercial (Synanthic 9,06%) en 22 cerdos naturalmente infectados, que recibieron una dosis oral de 30 mg/kg. Los cerdos fueron sacrificados a las ocho semanas postratamiento para evaluar quistes en en sus carcasas, y se determinó la eficacia cisticida a través de la proporción de quistes degenerados sobre el total. Solo se encontraron quistes degenerados en la musculatura, corazón y lengua de los cerdos tratados con OFZ en todos los grupos, lo cual muestra una eficacia del 100%. En los cerebros se encontraron quistes viables y degenerados, con una eficacia menor en todos los grupos (65% [OFZ comercial], 47% [OFZ local 22,5%] y 31% [OFZ local 10%], p = 0,355. Las formulaciones de OFZ producidas localmente fueron igual de efectivas que la formulación comercial y pueden proporcionar una alternativa para el tratamiento de la cisticercosis porcina.

The efficacy of two locally produced oxfendazole (OFZ) formulations against cysticercosis at 22,5% and 10%, versus a commercial formulation (Synanthic 9,06%) was evaluated in twenty-two naturally infected pigs that received a single oral dose of 30 mg/kg. Pigs were sacrificed at eight weeks post-treatment to evaluate the cysts found in their carcasses, and to determine the cysticidal efficacy, which was defined as the proportion of degenerated cysts over total cysts. Only degenerated cysts were found in muscle, heart, and tongue of pigs treated with OFZ in all groups, which shows an efficacy of 100%. Viable and degenerated cysts were found in brains, being the efficacy lower in all groups (65% [commercial OFZ], 47% [local OFZ 22.5%] and 31% [local OFZ 10%], p = 0.355). Locally produced OFZ formulations were similarly effective to the commercial formulation and may provide a practical alternative for the treatment of porcine cysticercosis.