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)

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.

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.

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.

Food handlers: an important reservoir of protozoans and helminth parasites of public health importance / Manipuladores de alimentos: um importante reservatório de protozoários e helmintos parasitas de importância para a saúde pública

Food handlers plays a primary role in the transmission of pathogenically important protozoans and helminth parasites. This study was aimed to evaluate the prevalence of intestinal pathogenic protozoans and helminth parasites among food handlers in and around University of Malakand, Lower Dir, Pakistan. Stool samples were collected from 642 food handlers (all of male) in a cross-sectional study from January to November, 2017. Wet Mount Techniques and concentration methods by using salt and formol–ether solutions. Three hundred and eighty four cases (59.8%) were found infected with one more parasites. Most of the individuals were found infected with helminth (47.6%) as compared to intestinal protozoans (0.93%). Seventy two cases (11.2%) of the cases presented mixed infection with both intestinal protozoan and helminth parasites. The order of prevalence for intestinal helminth was Ancylostoma duodenale (n = 258, 40.1%), followed by Taeniasa ginata (n=96, 14.9%) Ascaris lumbricoides (n = 54, 8.40%) and Trichuris trichura (n=30, 4.60%). For intestinal protozoa, Entamoeba histolytica/dispar (n = 36, 5.64%) was the only protozoan detected. Mono-parasitism was higher than poly-parasitism. Family size income and education level were the factors significantly (P<0.05) associated in the parasites prevalence. Current research showed that IPIs are primarily the foodborne pathogens still an important public health problem in Pakistan. Effective control programs on parasitic diseases transfer and their associated factors are recommended.

Os manipuladores de alimentos desempenham um papel fundamental na transmissão de protozoários e helmintos parasitas patogenicamente importantes. Este estudo teve como objetivo avaliar a prevalência de protozoários patogênicos intestinais e helmintos parasitas entre manipuladores de alimentos na Universidade de Malakand, Lower Dir, Paquistão. Amostras de fezes foram coletadas de 642 manipuladores de alimentos (todos do sexo masculino) em um estudo transversal de janeiro a novembro de 2017. Técnicas de montagem úmida e métodos de concentração usando soluções de sal e formol-éter. Trezentos e oitenta e quatro casos (59,8%) foram encontrados infectados com mais um parasita. A maioria dos indivíduos foi encontrada infectada por helmintos (47,6%) em comparação com protozoários intestinais (0,93%). Setenta e dois casos (11,2%) dos casos apresentavam infecção mista com protozoários intestinais e helmintos parasitas. A ordem de prevalência de helmintos intestinais foi Ancylostoma duodenale (n = 258, 40,1%), seguido por Taeniasa ginata (n = 96, 14,9%) Ascaris lumbricoides (n = 54, 8,40%) e Trichuris trichura (n = 30, 4,60 %). Para protozoários intestinais, Entamoeba histolytica / dispar (n = 36, 5,64%) foi o único protozoário detectado. Monoparasitismo foi maior do que poliparasitismo. A renda familiar e o nível de escolaridade foram os fatores significativamente (P <0,05) associados na prevalência de parasitos. A pesquisa atual mostrou que os IPIs são principalmente os patógenos de origem alimentar, ainda um importante problema de saúde pública no Paquistão. Programas eficazes de controle da transferência de doenças parasitárias e seus fatores associados são recomendados.

Cisticercosis hepática: a propósito de un caso y revisión de la literatura / Hepatic cysticercosis: a case report and review of the literature

Resumen La cisticercosis hepática es una enfermedad parasitaria bastante rara que consiste en el compromiso hepático por el cisticerco, con pocos casos reportados en la literatura, ninguno antes reportado en Colombia. Esta infección es producida por Cysticercus cellulosae, la forma larvaria del helminto Taenia solium. Es adquirida al consumir los huevos de la Tenia spp que se encuentran en la comida poco cocinada o el agua. En los casos reportados de cisticercosis hepática, el tratamiento se basa principalmente en el uso de antihelmínticos y en ocasiones quirúrgico. Se presenta el caso de un paciente mayor, indígena, quien consultó por melenas y dolor abdominal. En el examen físico se encontró hepatomegalia. Las imágenes diagnósticas plantean diagnóstico diferencial entre quiste hidatídico vs cistoadenoma/ cistoadenocarcinoma. El examen histopatológico sugiere compromiso por cisticercosis. Se reporta el caso de una cisticercosis hepática, con histología altamente sugestiva y hallazgos imagenológicos bastante inusuales a los previamente descritos en literatura. MÉD.UIS. 2020;33(2):101-108.

Abstract Hepatic cysticercosis is a quite rare parasitic disease consisting of hepatic involvement by the cysticercus, with few cases reported in the literature, none previously reported in Colombia. This infection is caused by Cysticercus cellulosae, the larval form of the Taenia solium helminth. It is acquired by consuming the Tenia sppeggs found in undercooked food or water. In reported cases of hepatic cysticercosis, treatment is based primarily on the use of anthelmintics and occasionally surgery. We present the case of an older, indigenous patient who consulted for melena and abdominal pain. Hepatomegaly is found on physical examination. Diagnostic images suggested a differential diagnosis between hydatid cyst vs. cystadenoma / cystadenocarcinoma. Histopathological examination suggested compromise due to cysticercosis. The case of hepatic cysticercosis is reported, with highly suggestive histology and imaging findings quite unusual to those previously described in the literature. MÉD.UIS. 2020;33(2):101-108.

Cisticercose bovina: ocorrência em abatedouro de Sertãozinho, SP, e relação com a teníase e cisticercose humana

O presente trabalho teve como objetivo verificar a incidência de cisticercose bovina em 2.519 bovinos, encaminhados ao Departamento de Inspeção Final (D.I.F) de um abatedouro frigorífico, sob inspeção federal, localizado em Sertãozinho-SP. Esses animais eram oriundos de diferentes cidades dos estados de São Paulo, Minas Gerais e Goiás, sendo possível o uso do respectivo abatedouro, durante o período de junho de 2018 a dezembro de 2018, como um recinto de convergência desses bovinos para estudo de caráter epidemiológico e, portanto, servindo para representar a situação sanitária do rebanho nessa região. Foram selecionados os 3 municípios em que se detectaram as maiores incidências de cisticercose bovina para tentar, depois, relacioná-las com as incidências, nos mesmos municípios, de teníase e cisticercose humana. Para tanto, contactouse as respectivas secretarias de saúde dos aludidos municípios, na tentativa de fechamento do ciclo zoonótico e levantamento da hipótese sobre a causa raiz do complexo nessas áreas. Com foco, sobretudo, em evidenciar o problema aos órgãos de saúde responsáveis pelo devido controle sanitário. Os dados foram obtidos através do Serviço de Inspeção Federal (SIF n° 941), indicando o município de origem, número de diagnosticados e as patologias dos bovinos encaminhados ao D.I.F, para a realização do compilado, que indicou 2357 animais infectados pela cisticercose bovina, sendo as cidades com os maiores níveis de infestação : São Bento do Sapucaí-SP, Agudos-SP e São João da Boa Vista-SP.

This study aimed to analyze the prevalence of bovine cysticercosis in 2,519 animals, sent to the Department of Final Inspection (D.I.F) of a slaughterhouse, under federal inspection, located in Sertãozinho-SP. These cattle came from different cities in the states of São Paulo, Minas Gerais and Goiás, making it possible to use the respective slaughterhouse, during the period from June 2018 to December 2018, as a place of convergence of these cattle for an epidemiological study. , showing the zoonosis surveillance itself in its origins. The 3 counties with the highest incidence were selected to establish the relationship and, subsequently, the contact with the human part, health departments, in search for data on human teniasis and cysticercosis, in an attempt to close the zoonotic cycle and raise the hypothesis about the root cause of the complex in those areas. With a focus, above all, on highlighting the problem to the health agencies responsible for the control. The data were obtained through the local SIF (Federal Inspection Service) (941), indicating the animal’s origin’s county, number of diagnosed and the pathologies of the cattle which were sent to the D.I.F, for the compilation, which indicated 2357 animals infected by cysticercosis, with the cities with the highest levels of infestation. : São Bento do Sapucaí-SP, Agudos-SP and São João da Boa Vista-SP.

Evaluación del método de ELISA para detección de anticuerpos anti-cisticercos en sueros humanos / Evaluation of the ELISA method for the detection of anti-cysticercus antibodies in human sera / Avaliação do método ELISA para a detecção de anticorpos anti-cisticercos em soros humanos

La neurocisticercosis (NCC) es la localización en el sistema nervioso central (SNC) humano de la parasitosis provocada por el estadio larvario de la Taenia solium, el cisticerco, que prevalece en áreas urbanas y rurales y constituye un problema de salud pública. El diagnóstico puede efectuarse por exploración imagenológica del SNC con resonancia magnética o tomografía axial computarizada, no siempre disponible, y por pruebas de inmunoensayo (EIA) en sangre, que aportan al diagnóstico rapidez, bajo costo y transferibilidad. Para evaluar su capacidad diagnóstica y validar la precisión de la técnica de ELISA (ensayo inmunoabsorbente ligado a enzimas), en la detección de anticuerpos anti-cisticercos en sueros humanos, se diseñó una seroteca en forma aleatoria y en doble ciego, y se realizó el ELISA con las muestras, utilizando placas sensibilizadas con antígenos obtenidos del fluido vesicular de cisticercos de T. solium. Para la validación se realizaron 20 ensayos empleando controles positivos y negativos, por cuadruplicado en diferentes días, y realizados por más de un operador; el punto de corte para este método fue una densidad óptica de 0,325. La precisión intralaboratorio para el control débil (media=0,532±0,09) fue de %CV=17,51±0,09, y un valor de repetibilidad de %CV=7,04±0,04, cifras que se encuentran dentro de los límites esperados para el método. Con estos resultados se puede concluir que la precisión del ELISA para el serodiagnóstico de NCC se encuentra validada. El ensayo validado proporcionó resultados coherentes y repetidos que permitieron discriminar entre dos resultados dicotómicos y establecer con exactitud la condición de una posible infección, con un nivel de certidumbre estadística predeterminado.

Neurocysticercosis (NCC) is the location in the human central nervous system (CNS) of the parasitosis caused by the larval stage of Taenia solium, the cysticercus which prevails in urban and rural areas, constituting a public health problem. Diagnosis can be made by CNS imaging with magnetic resonance or computerized axial tomography, not always available, and by blood immunoassay (EIA) tests, which provide rapidity, low cost and transferability. In order to evaluate its diagnostic capacity and validate the ELISA (Enzyme- Linked ImmunoSorbent Assay) technique in the detection of anti-cysticercus antibodies in human sera, a collection of sera was designed in a randomized and double-blind manner, and the ELISA was performed with the samples, using plates sensitized with antigens obtained from the vesicular fluid of T. solium cysticerci. Twenty trials were conducted, using positive and negative controls, in quadruplicate, on different days, and performed by more than one operator; the cutoff for this method was an optical density of 0.325. The intralaboratory precision for the weak control (mean=0.532±0.09) was %CV=17.51±0.09, and a repeatability value of %CV=7.04±0.04, figures that are within the expected limits for the method, It can be concludedthat the accuracy of the ELISA for serodiagnosis of NCC is validated. The validated test provided consistent and repeated results, which made it possible to discriminate between two dichotomous outcomes, and to establish with accuracy the condition of a possible infection, with a predetermined level of statistical certainty.

A neurocisticercose (NCC) é o local no sistema nervoso central (SNC) humano de parasitose causada pelo estágio larval da Taenia solium, o cisticerco, prevalecente em áreas urbanas e rurais, constituindo um problema de saúde pública. O diagnóstico pode ser feito por varredura imagenológica do SNC com ressonância magnética ou tomografia axial computadorizada, nem sempre disponível, e por testes de imunoensaio (EIA) em sangue, que fornecem ao diagnóstico rapidez, baixo custo e portabilidade. Para avaliar a sua capacidade de diagnóstico e validar a precisão da técnica de ELISA (ensaio imunoabsorvente ligado a enzimas), na detecção de anticorpos anti-cisticercos em soros humanos, um serrarium foi projetado em forma aleatória e em duplo cego, e foi realizado com as amostras o ELISA, utilizando placas sensibilizadas com antígenos derivados do fluido vesicular de cisticercos de T. solium. 20 testes para validação foram realizados, utilizando controles positivos e negativos, em quadruplicado, em dias diferentes, e realizados por mais de um operador; o ponto de corte para este método era uma densidade óptica de 0,325. A precisão intralaboratorial para o controle fraco (média=0,532±0,09) foi de CV%=17,51±0,09, e um valor de repetibilidade de CV%=7,04±0,04, valores que estão dentro dos limites esperados para o método, podendo concluir com esses resultados que a precisão do ELISA para diagnóstico sorológico de NCC é validado. O ensaio validado forneceu resultados consistentes e repetidos, o que permitiu discriminar entre dois resultados dicotômicos e identificar com exatidão a condição de possível infecção com um nível de certeza pré-determinado estatisticamente.

Levantamento de casos de cisticercose no extremo sul da Bahia no período de 2014 a maio 2017 / Survey of cases of cysticercosis in the south end of Bahia for the period 2014 to may 2017

A cisticercose é um agravo de origem parasitária. A zoonose é relevante no contexto da higiene da carne, do ponto de vista social, econômico - sanitário e de saúde coletiva. A escolha da pesquisa fundamentou-se na carência de estudos acerca do tema na região e na importância da utilização das informações no planejamento e implementação de políticas públicas de saúde, identificar a cidade de origem do animal infectado, calcular o percentual da perda econômica na microrregião em decorrência do número de carcaças com cisticercose. Nos quatro anos, foram abatidos e inspecionados 355.208 bovinos, na microrregião do extremo sul da Bahia (Alcobaça, Caravelas, Itamaraju, Itanhém, Jucuruçu, Lajedão, Medeiros Neto, Mucuri, Nova Viçosa, Prado, Teixeira de Freitas, Ibirapuã e Vereda). O presente trabalho teve como objetivos descrever a prevalência de cisticercose em bovinos abatidos em frigorífico sob inspeção federal no extremo sul da Bahia no período de janeiro de 2014 a maio de 2017.

Molecular phylogenetic analysis of Cysticercus ovis from Egypt based on MT-CO1 gene sequences / Análise filogenética molecular de Cysticercus ovis do Egito com base nas sequências do gene MT-CO1

Abstract Cysticercus ovis or sheep measles is the larval stage of Taenia ovis, which is the intestinal tapeworm of dogs. It is found in the cardiac and skeletal muscles of sheep and can be the cause of partial or total condemnation of carcasses at abattoirs. The aim of the current work was to determine the prevalence of C. ovis among sheep in Upper Egypt and to present the molecular and phylogenetic analysis of this using the amplified Mitochondrial Cytochrome Oxidase subunit 1 (MT-CO1) gene. A total of 1885 sheep slaughtered at local abattoirs of 4 different governorates of Upper Egypt (Asuit, Sohag, Qena and Aswan) were carefully examined for C. ovis. The overall prevalence of infection was 2.02%. The highest rate of infection was observed in adult animals over 4 years of age (44.73%). There was no significant effect of animal sex on infection rates. The phylogenic analysis of C. ovis Egyptian isolates showed very close similarity to the New Zealand isolate (AB731675). This is the first report showing the genetic analysis of C. ovis in Egypt, which provides a very powerful tool for taxonomy and definitive diagnosis of C. ovis, which could be helpful for preventive and control programs.

Resumo Cysticercus ovis "sheep measles" é o estágio larval da Taenia ovis, encontrada nos músculos de carneiros, causado pela ingestão de ovos de Taenia ovis, parasita de cães. O objetivo do presente trabalho foi determinar a prevalência de C. ovis entre ovinos no Alto Egito e apresentar as análises moleculares e filogenéticas, utilizando o gene da subunidade mitocondrial citocromo-oxidase amplificada 1 (MT-CO1). Um total de 1885 ovinos abatidos em matadouros locais de 4 províncias diferentes do Alto Egito (Asuit, Sohag, Qena e Aswan) foram cuidadosamente examinados para C. ovis. A prevalência geral de infecção foi de 2,02%. A maior taxa de infecção foi observada em animais adultos com mais de 4 anos de idade (44,73%). Não houve efeito significativo do sexo nas taxas de infecção. A análise filogenética de isolados egípcios de C. ovis mostrou uma similaridade muito próxima ao isolado da Nova Zelândia (AB731675). Este é o primeiro relato mostrando a análise genética de C. ovis no Egito, fornecendo uma ferramenta para taxonomia e diagnóstico definitivo de C. ovis, podendo ser útil para programas preventivo e de controle.

Perfil epidemiológico da cisticercose bovina e suína em três regiões do estado de Minas Gerais, Brasil / Epidemiological profile of bovine and swine cysticercosis in three regions of Minas Gerais State, Brazil

Com o objetivo de avaliar a situação epidemiológica da cisticercose suína e bovina na zona rural de cinco municípios, distribuídos em três distintas regiões do estado de Minas Gerais, foi determinada a prevalência das cisticercoses bovina e suína nas propriedades rurais e os principais fatores de risco que poderiam favorecer a transmissão e manutenção da doença nas referidas propriedades. A pesquisa abrangeu 388 propriedades, localizadas em 91 diferentes comunidades rurais, sendo coletadas 1.792 amostras de sangue bovino e 554 de suíno. Além da avaliação das referidas amostras laboratoriais (ELISA indireto e imunoblot), também foram analisados os dados obtidos da aplicação de um questionário para cada propriedade, no qual constava as informações sobre as condições socioeconômicas, higiênico-sanitárias e as relacionadas ao sistema de criação animal. A prevalência da cisticercose variou de 0,3 a 5,9% nos bovinos e de 0 a 2,8% nos suínos criados artesanalmente nesses municípios pesquisados. Os principais fatores de risco de transmissão identificados foram a fonte de água consumida, a origem da carne, a natureza do município e da região, para a cisticercose bovina, e o destino do esgoto e o sistema de criação, para a cisticercose suína.(AU)

In order to evaluate the epidemiological situation of porcine and bovine cysticercosis in the rural area of five municipalities, distributed in three different regions of the state of Minas Gerais, Brazil, the prevalence of bovine and porcine cysticercosis was determined in the rural properties as well as the main risk factors that may favor the transmission and maintenance of the disease in these properties. The research covered 388 farms, located in 91 different rural communities, with 1,792 samples of bovine blood and 554 of swine collected. In addition to the evaluation of these laboratory samples (indirect ELISA and Imunoblot), the data obtained from the application of a questionnaire for each property were also analyzed, with information on socioeconomic, hygienic-sanitary and animal-related conditions. The prevalence of cysticercosis ranged from 0.3 to 5.9% in cattle and from 0 to 2.8% in the pigs raised in these municipalities. Among the main risk factors for transmission of bovine cysticercosis were the source of water consumed, the origin of the meat, the nature of the municipality and the region. Regarding the pigs, risk factors were the sewage disposal and animal management system.(AU)

Status of common parasitic diseases in Korea in 2019

This study aimed to determine the status of common parasitic disease in Korea in 2019. Twelve parasitic diseases were selected: toxocariasis, anisakiasis, paragonimiasis, sparganosis, cysticercosis, toxoplasmosis, clonorchiasis, enterobiasis, trichuriasis, trichomoniasis, cryptosporidiosis, and malaria. Their biology, epidemiology, pathogenesis, symptoms and signs, diagnosis, treatment, and prognosis were evaluated. Of the parasitic diseases, toxocariasis was the most prevalent according to serological results. Anisakiasis should be considered when acute gastrointestinal symptoms occur with a recent past history of raw seafood ingestion. Paragonimiasis, sparganosis, and cysticercosis can be diagnosed using an enzyme-linked immunosorbent assay; thus, enzyme-linked immunosorbent assay needs to be performed for suspected cases. Toxoplasmosis and cryptosporidiosis are opportunistic infections. The symptoms and signs are aggravated under immunocompromised conditions. Although the egg positivity rate of Clonorchis sinensis is higher than that of other intestinal parasitic diseases, encountering patients with complaints of symptoms caused by clonorchiasis is rare because the worm burden is low. Trichomoniasis is usually managed by gynecologists; therefore, it should be included in the differential diagnoses of vaginal diseases. The annual number of malaria cases has decreased, although it remains at approximately 500 cases per year. Malaria should be suspected when symptoms such as intermittent fever, headache, and splenomegaly are noted especially when the patients reside near demilitarized zones. Although the prevalence and number of reported cases of parasitic diseases have decreased in Korea, we should consider parasitic diseases in the list of differential diagnoses.

Advances in Serological Diagnosis of Taenia solium Neurocysticercosis in Korea

Cysticercosis, a parasitic disease caused by Taenia solium metacestode (TsM), has a major global public health impact in terms of disability-adjusted life years. The parasite preferentially infects subcutaneous tissue, but may invade the central nervous system, resulting in neurocysticercosis (NC). NC is an important neglected tropical disease and an emerging disease in industrialized countries due to immigration from endemic areas. The prevalence of taeniasis in Korea declined from 0.3%–12.7% during the 1970s to below 0.02% since the 2000s. A survey conducted from 1993 to 2006 revealed that the percentage of tested samples with high levels of specific anti-TsM antibody declined from 8.3% to 2.2%, suggesting the continuing occurrence of NC in Korea. Modern imaging modalities have substantially improved the diagnostic accuracy of NC, and recent advances in the molecular biochemical characterization of the TsM cyst fluid proteome also significantly strengthened NC serodiagnosis. Two glycoproteins of 150 and 120 kDa that induce strong antibody responses against sera from patients with active-stage NC have been elucidated. The 150 kDa protein showed hydrophobic-ligand binding activities and might be critically involved in the acquisition of host-derived lipid molecules. Fasciclin and endophilin B1, both of which play roles in the homeostatic functions of TsM, showed fairly high antibody responses against calcified NC cases. NC is now controllable and manageable. Further studies should focus on controlling late-onset intractable seizures and serological diagnosis of NC patients infected with few worms. This article briefly overviews diagnostic approaches and discusses current issues relating to NC serodiagnosis.

Subcutaneous nodules of cysticercosis as a sign of asymptomatic neurocysticercosis in an HIV positive patient

Abstract Cysticercosis is caused by the hematogenous dissemination of the larval form (cysticercus) of Taenia solium. It can affect any organ or tissue in the body but commonly affects the subcutaneous tissue, central nervous system, eyes, and skeletal muscle. Skin lesions can assist as a marker in the diagnosis of asymptomatic neurocysticercosis in endemic areas. A 49-year-old HIV positive man presented with multiple cutaneous nodules confirmed as cysticercomas which led to the diagnosis of asymptomatic neurocysticercosis. He was successfully treated with albendazole and steroids at recommended doses with no adverse effects.

Occurrence of hydatidosis and cysticercosis in cattle in southern Rio Grande do Sul, Brazil, from 2013 to 2016 / Ocorrência de hidatidose e cisticercose em bovinos na região sul do Rio Grande do Sul, de 2013 a 2016

Hydatidosis and cysticercosis are parasitoses caused by the larval forms of the cestodes Equinococcus spp. and Taenia spp., which belong to the Taeniidae family. Their definitive hosts are canids and humans, respectively, with ruminants as the intermediate hosts and humans as an accidental host of both diseases. These parasites are responsible for large economic losses in slaughterhouses due to condemnation of carcasses and by-products. The present study reports the mean incidence rates of hydatidosis and cysticercosis in cattle slaughtered in the southern region of Rio Grande do Sul state, Brazil. The incidence rates observed between 2013 and 2016 were 19.96% and 0.9%, respectively, with decreased tendency of occurrence of both diseases in those years. Despite the downward tendency of the diseases, hydatidosis presented high incidence. Hydatidosis performance over the years was characterized by significant increase in the number of cases, followed by marked decrease. Cysticercosis presented a decrease in number of cases at the beginning and the end of each year. These diseases have a significant socioeconomic impact as they are responsible for large losses in the livestock industry, due to reduced productivity and carcass condemnation, and represent a risk to public health.(AU)

Hidatidose e cisticercose são parasitoses causadas pelas formas larvais dos cestódeos Equinococcus spp. e Taenia spp., pertencentes a família Taeniidae, possuem como hospedeiros definitivos canídeos e o homem respectivamente, sendo os ruminantes os hospedeiros intermediários, e o homem um hospedeiro acidental, em ambas as doenças. Estas parasitoses são responsáveis por grandes perdas econômicas em frigoríficos, devido a condenações de carcaças e subprodutos. O presente artigo relata que a incidência média de hidatidose e cisticercose em bovinos abatidos na região sul do Rio Grande do Sul, entre os anos de 2013 e 2016, foi de 19,96% e 0,9% respectivamente, sendo avaliada uma tendência de queda no número de casos de ambas as doenças ao longo dos anos analisados. Apesar da tendência de queda das doenças, a hidatidose apresentou uma alta incidência. O comportamento da hidatidose ao longo dos anos foi caracterizado por aumentos significativos no número de casos da doença, seguidos por acentuadas quedas. Já a cisticercose apresentou uma diminuição no número de casos no início e no final de cada ano. Estas doenças apresentam grande impacto socioeconômico, pois são responsáveis por grandes perdas na pecuária, por redução na produtividade e condenações, além de representarem um risco à saúde pública.(AU)

Complexo teníase / cisticercose: uma revisão / Complex teniasis / cysticercosis: a review

As verminoses são doenças frequentes causadas por diferentes tipos de vermes. A teníase e a cisticercose são duas entidades mórbidas distintas, causadas, respectivamente, pelas Tenia e sua forma larvária Cysticercus cellulosae. O complexo teníase/cisticercose é causado pela mesma espécie de cestódio, em fases diferentes do seu ciclo de vida. Estas verminoses podem contaminar o homem por meio de alimentos contaminados. O controle dessas doenças tem como estratégia fundamental a interrupção do ciclo de vida do parasito, por meio de controle higienicossanitário. Neste trabalho realizou-se um levantamento bibliográfico, buscando ressaltar as principais características destas verminoses, sua epidemiologia, forma de diagnóstico e controle realizado pela indústria de alimentos para segurança dos consumidores.

Verminoses are common diseases caused by different types of worms. Teniasis and cysticercosis are two distinct morbid entities caused, respectively, by the Tenia and its larval form - Cysticercus cellulosae. The teniasis / cysticercosis complex is caused by the same species of cestode considering its different stages of its life cycle. Since these verminoses can contaminate humans through (contaminated) food, the control of these diseases has as its main strategy the interruption of the life cycle of the parasite, through hygienicosanitary control. This work is a bibliographical survey, seeking to highlight the main characteristics of these verminoses, its epidemiology, diagnosis and control by the food industry to prevent contamination of consumers.

Seroprevalence of human cysticercosis in Jataí, Goiás state, Brazil

ABSTRACT The Taenia solium cysticercosis affects millions of people worldwide and is considered a public health problem, especially in developing countries. The diagnosis of neurocysticercosis is complex and involves the analysis of epidemiological, clinical, neuroimaging, and immunological host data. Neurocysticercosis is endemic in Brazil, and is related to the cause of death mainly in the Southeast, South, and Central-West regions. The objective of this study was to determine the seroprevalence of cysticercosis in inhabitants of the city of Jataí, Goiás, in the Central-West region of Brazil from April to August 2012. A total of 529 serum samples were analyzed by enzyme-linked immunosorbent assay for detecting IgG antibodies against T. solium larvae, and Western blotting was used for confirming the diagnosis through the recognition of at least two specific peptides from their serum antibodies. The 351/529 (66.3%) reactive samples were analyzed by enzyme-linked immunosorbent assay and Western blotting confirmed the diagnosis in 73 samples that recognized at least two of the following peptides specific IgG antibodies for cysticercosis: 18, 24, 28-32, 39-42, 47-52, 64-68, and 70 kDa. The seroprevalence of cysticercosis was 13.8% (95% CI 5.9-21.7), demonstrating that the studied area is endemic to this disease.

Perfil da implantação de cisticercos de Taenia saginata em sítios musculares não usuais e sua importância para a Saúde Pública / Profile of Taenia saginata cysticerci implantation in unusual sites and its importance for public health

A cisticercose bovina é uma zoonose de distribuição mundial. No Brasil, o controle é realizado através do diagnóstico anatomopatológico durante a inspeção post-mortem nos matadouros. Objetivou-se neste estudo determinar a localização de cisticercos nos tecidos rotineiramente inspecionados e sobretudo nos tecidos não rotineiramente inspecionados, verificando a viabilidade dos cisticercos em bovinos infectados de forma experimental (grupo 1) e natural (grupo 2) com ovos de Taenia saginata. Em ambos os grupos foram analisados os tecidos rotineiramente inspecionados nas linhas de inspeção, de acordo com os padrões estabelecidos na legislação do Brasil. Adicionalmente, no grupo 1 foram selecionadas outras regiões anatômicas, representadas por quatro cortes comerciais (acém, alcatra, contrafilé, paleta), além do fígado, esôfago, diafragma e pilares. Com relação à frequência dos cisticercos no grupo 1, nos cortes comerciais, foram encontrados 8,2% de cisticercos no acém, 6,6% na paleta, 6,2% no contrafilé e 5,8% na alcatra. Outros tecidos não rotineiramente inspecionados para a exclusiva pesquisa por cisticercos que apresentaram lesões foram o diafragma, fígado e o esôfago, com 2,7%, 12,0% e 1,2% respectivamente. No grupo 1, os sítios rotineiramente inspecionados predominantes foram o coração (37,7%), músculos mastigatórios (17,1%) e língua (2,3%). No grupo 2 foram encontrados 61,8% dos cisticercos totais no coração, seguido dos músculos mastigatórios (38,2%) e fígado (10,2%). Com relação à viabilidade dos cisticercos no grupo 1, os viáveis predominaram na alcatra (80,0%), diafragma (71,4%) e esôfago (66,7%), já os cisticercos inviáveis predominaram nos músculos mastigatórios (77,3%), coração (76,3%), fígado (71,0%) e língua (50%). No grupo 2, o fígado apresentou 87,5% de cisticercos inviáveis, seguidos da língua (66,7%) e coração (63,2%), e nos tecidos mastigatórios foram encontrados 68,3% de cisticercos viáveis (68,3%). O alto percentual de cisticercos viáveis encontrado nos cortes comerciais, inclusive nos bovinos naturalmente infectados, representa um alerta para a Saúde Pública, pois, no Brasil, são frequentemente consumidos sem sofrer o devido tratamento térmico para inativação do cisticerco, aumentando consideravelmente a chance de infecção por teniose. Os resultados revelaram amplo perfil da manifestação anatomopatológica da cisticercose em diferentes tecidos de bovinos experimentalmente e naturalmente infectados, considerando-se tecidos musculares rotineiramente inspecionados ou não. Assim, o aprimoramento da inspeção sanitária das carcaças bovinas pode incrementar o controle do complexo teniose-cisticercose, diminuindo os riscos para a saúde pública.(AU)

Cysticercosis is a worldwide zoonosis, which demands proper control and monitoring during all beef production chain. In Brazil, the key point for controlling this zoonosis is the anatomopathological exam conducted in slaughterhouses during the post-morten inspection. This study aimed to describe the cysticerci location in tissues not usually examined during the inspection, and to check their viability in bovines infected with Taenia saginata eggs (group 1: experimental; group 2: natural). After slaughtering, animal from both groups were routinely examined for cysticercosis, according official Brazilian standards; group 1 animals were also examined in additional anatomic regions: end cuts (chuck, rump, strip loin, and shoulder), liver, esophagus, diaphragm and pillars. In group 1, cysticerci were identified in chuck (8.2%), shoulder (6.6%), strip loin (6.2%), and rump (5.8%), and also in tissues that are not usually considered during routine inspection, such as diaphragm (2.7%), liver (12.0%) and esophagus (1.2%). Still in group 1, the routine inspection identified cysticerci in hearth (37.7%), head muscles (17.1%), and tongue (2.3%). In group 2, cysticerci were identified in hearth (61.8%), head muscles (38.2%), and liver (10.2%). The viability of cysticerci were predominant in rump (80.0%), diaphragm (71.4%) and esophagus (66.7%) in animals from group 1, while non-viable cysticerci were more frequent in head muscles (77.3%), hearth (76.3%), liver (71.0%), and tongue (50.0%). In group 2, head muscles presented 68.3% of the viable cysticerci, while non-viable cysticerci were identified in liver (87.5%), tongue (66.7%), and hearth (63.2%). The high frequencies of viable cysticerci in end cuts available for consumers, including natural infected bovines, is a Public Health concern, once in Brazil these products were usually consumed without proper heat treatment, increasing the risks of T. saginata infection. The obtained results demonstrated the anatomopathological distribution of cysticercosis in different tissues in experimental and natural infected bovines, considering tissues that are routinely and not routinely examined during inspection. Then, the inspection procedures could be improved by adding such analysis in its routine procedures, in order to increase the proper control of the taeniasis-cysiticercosis complex and to decrease the Public Health risks.

Apuntes y recomendaciones para el establecimiento de programas de control de la teniasis / cisticercosis por Taenia solium en el Perú / Notes and recommendations for the establishment of control programs for taeniasis and cysticercosis due to Taenia solium in Peru

La neurocisticercosis es la infección del sistema nervioso por la larva (cisticerco) de la tenia del cerdo (Taenia solium). La neurocisticercosis es la mayor causa de epilepsia adquirida a nivel mundial y por ende un problema de salud pública global. De otro lado, la teniasis/cisticercosis por T. solium es una de las pocas infecciones consideradas potencialmente erradicables. Recientemente, un programa de eliminación de transmisión a gran escala en Tumbes, Perú, demostró la factibilidad de interrumpir la transmisión. Sobre la base de estos avances, se proponen una serie de lineamientos iniciales para poner las bases de programas de control regionales y nacionales de la teniasis/cisticercosis, partiendo de intervenciones simples y factibles a nivel local.

Neurocysticercosis is a nervous system infection caused by the larvae (cysticercus) of the pork tapeworm (Taenia solium). Neurocysticercosis is the primary cause of acquired epilepsy worldwide and, therefore, a global public health problem. On the other hand, T. solium taeniasis/cysticercosis is one of very few infectious diseases considered to be potentially eradicable. Recently, a large-scale elimination program in Tumbes, Peru, demonstrated the feasibility of interrupting transmission. Based on these advances, a series of initial guidelines are proposed aimed at setting out the foundations for regional and national taeniasis/cysticercosis control programs, with simple and feasible local interventions as a starting point.

Intradural Extramedullary Cysticercosis Involving the Thoracolumbar Spinal Canal in a Patient with Cerebral Cysticercosis / 대한정형외과학회잡지

Neurocysticercosis (NCC) by Taenia solium is the most common parasitic infection of the central nervous system involving the cerebrum. However, spinal involvement of NCC is rare. Spinal NCC can cause radiculopathy, myelopathy, cauda equina syndrome, and even paraparesis, depending on its location and size. Spinal NCC may require surgical treatment as a first-line treatment because medical therapy can further aggravate the inflammation due to dead cysts, resulting in clinical deterioration. The current standard therapy for spinal NCC is surgical decompression followed by medical therapy. We experienced a case of widespread thoracolumbar intradural extramedullary cysticercosis involving the spinal canal with cerebral cysticercosis. We report this rare case with literature review.