Cysticercosis is an infection caused by a tapeworm known as Taenia solium. Globally, there are around 50 million patients who are suffering from cysticercosis. High cases are reported (endemic) in Asia, sub-Saharan Africa, India, Central America, and South America. Rural areas have a higher number of cases compared to urban areas. People become infected as a result of eating undercooked pork which is contaminated by tapeworm and its larvas. Other than that, people can also get infected by ingesting Taenia solium eggs which are shed in the stool of a person who is a carrier or infected. Rural areas where pigs are raised with poor hygiene reported having the highest cases of cysticercosis. Living and having close contact for some time with a carrier can also put someone healthy at risk of getting infected. Cysticercosis diagnosis and treatment will also be discussed in this article.
Following the ingestion of tapeworm eggs, the eggs will later hatch and the embryos released will invade the muscles, intestines, liver, brain, and other tissues. Tapeworms may stay for years in the intestine. These adult tapeworms will also lay eggs. An adult tapeworm may grow up to seven-meter in length. Preventions are crucial in controlling the spread of this disease. The strategies in preventing this disease are:
- Prevent tapeworms infection in human
Inspection of raw pork meat for any larva. Larvas are visible in raw pork meat. This method is a success in developed countries. Other than that, freezing and adequate cooking are also effective in preventing tapeworms infection in humans as both methods can kill tapeworms larvas. Antiparasitic agents can also be given to pigs, but this approach is not effective enough.
- Prevent tapeworms infection in pigs
Proper disposal of human waste and confine pigs help prevent tapeworms infection in pigs. Pigs should not have any contact with human waste materials as this may result in infection.
- Reducing transmission from one person to another
Educate the community on how this disease spread and transmitted. Maintaining good personal hygiene and proper handwashing technique. Treat all the carriers with medication.
The clinical features for cysticercosis are:
- Visual disturbances
- Eye pain
History taking is important to analyze all important information needed to conclude a diagnosis of cysticercosis. A doctor will ask you a list of questions during this session. Physical examination and investigations are needed on top of history taking to confirm a diagnosis of cysticercosis. The investigations that can be done are:
- Computed Tomography (CT) scan
- Magnetic Resonance Imaging (MRI)
- Serology test
- Lumbar puncture for cerebrospinal fluid (CSF) analysis
- Brain biopsy for further study under the microscope
The treatment mainly consists of antiseizure and antiparasitic medications. Examples of antiseizure medications are phenytoin and carbamazepine. Antiparasitics are often given in combination. The combination usually consists of praziquantel and albendazole. Corticosteroids should also be given along with the antiparasitics regime. Dexamethasone is the corticosteroid preferred. The duration of treatment is around two weeks. Untreated cysticercosis may result in the following complications:
- Spinal cord lesions
- Eye lesions
Till now, there is no available vaccine discovered to prevent this disease. Other preventive measures are listed earlier in this article should be taken.