Treatment of cysticercosis with praziquantel at the Bangkok Hospital for Tropical Diseases.

ABSTRACT

Twelve patients with cysticercosis including two cases of subcutaneous cysticercosis and ten cases of combined subcutaneous and, cerebral cysticercosis were treated with praziquantel 30 mg per kilogram of body weight daily in 3 divided doses for 10 days. To minimize possible reactions due to the death of parasites prednisolone 10 mg three times a day was also given in most cases. During treatment, an intense inflammatory reaction occurred as evidenced by increased intracranial pressure and convulsions. Histopathological findings studied at 2 weeks post treatment revealed lymphocytic and plasma cell infiltrations with destruction of the larvae. Clinical response was evident at one week post treatment, manifested by a significant decrease in size of the subcutaneous cysts which gradually disappeared at the end of three months. Radiology of soft tissues showed distortion of semicalcified cysts. Brain computerized tomography at 6 months post treatment showed disappearance of the cysts presumed to be due to death of cystercerci and marked reduction in numbers and size of other stages of cysts. Mild and transient side effects were observed in 25% of cases. Two patients (17%) had severe side effects and one (8%) had convulsions during treatment.