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Cysticercosis
(SIS-tuh-sir-KO-sis)
What is cysticercosis?
Cysticercosis is an
infection caused by the pork tapeworm, Taenia solium. Infection
occurs when the tapeworm larvae enter the body and form cysticerci (SIS-tuh-sir-KEY)
(cysts). When cysticerci are found in the brain, the condition is called
neurocysticercosis (NEW-row SIS-tuh-sir-KO-sis).
Where is cysticercosis found?
The tapeworm that
causes cysticercosis is found worldwide. Infection is found most
often in rural, developing countries with poor hygiene where pigs are
allowed to roam freely and eat human feces. This allows the tapeworm
infection to be completed and the cycle to continue. Infection can occur,
though rarely, if you have never traveled outside of the United States.
Taeniasis and cysticercosis are very rare in Muslim countries where eating
pork is forbidden.
How can I get cysticercosis?
By accidentally
swallowing pork tapeworm eggs. Tapeworm eggs are passed in the bowel
movement of a person who is infected. These tapeworm eggs are spread
through food, water, or surfaces contaminated with feces. This can happen
by drinking contaminated water or food, or by putting contaminated fingers
to your mouth. A person who has a tapeworm infection can reinfect
themselves (autoinfection). Once inside the stomach, the tapeworm egg
hatches, penetrates the intestine, travels through the bloodstream and may
develop into cysticerci in the muscles, brain, or eyes.
What are the signs and symptoms
of cysticercosis?
Signs and symptoms will
depend on the location and number of cysticerci in your body.
Cysticerci in the
muscles:
Cysticerci in the
muscles generally do not cause symptoms. However, you may be able to
feel lumps under your skin.
Cysticerci in the
eyes:
Although rare,
cysticerci may float in the eye and cause blurry or disturbed vision.
Infection in the eyes may cause swelling or detachment of the retina.
Neurocysticercosis (cysticerci
in the brain, spinal cord):
Symptoms of
neurocysticercosis depend upon where and how many cysticerci (often
called lesions) are found in the brain. Seizures, and headaches are the
most common symptoms. However, confusion, lack of attention to people
and surroundings, difficulty with balance, swelling of the brain (called
hydrocephalus) may also occur. Death can occur suddenly with heavy
infections.
How long will I be infected
before symptoms begin?
Symptoms can occur
months to years after infection, usually when the cysts are in the process
of dying. When this happens, the brain can swell. The pressure caused by
swelling is what causes most of the symptoms of neurocysticercosis. Most
people with cysticerci in muscles won’t have symptoms of infection.
How is cysticercosis diagnosed?
Diagnosis can be
difficult and may require several testing methods. Your health care
provider will ask you about where you have traveled and your eating
habits. Diagnosis of neurocysticercosis is usually made by MRI or CT brain
scans. Blood tests are available to help diagnose an infection, but may
not always be accurate. If surgery is necessary, confirmation of the
diagnosis can be made by the laboratory.
What should I do if I think I
have cysticercosis?
See your health care
provider.
Is there treatment for
cysticercosis?
Yes. Infections are
generally treated with anti-parasitic drugs in combination with anti-imflammatory
drugs. Surgery is sometimes necessary to treat cases in the eyes, cases
that are not responsive to drug treatment, or to reduce brain edema
(swelling). Not all cases of cysticercosis are treated.
I have been diagnosed with
neurocysticercosis. My health care provider has decided not to treat me.
How was this decision made?
Often, the decision of
whether or not to treat neurocysticercosis is based upon the number of
lesions found in the brain and the symptoms you have. When only one lesion
is found, often treatment is not given. If you have more than one lesion,
specific anti-parasitic treatment is generally recommended.
If the brain lesion is
considered calcified (this means that a hard shell has formed around the
tapeworm larvae), the cysticerci is considered dead and specific
anti-parasitic treatment is not beneficial.
As the cysticerci die,
the lesion will shrink. The swelling will go down, and often symptoms
(such as seizures) will go away.
Can infection be spread from
person to person?
No. Cysticercosis is
not spread from person to person. However, a person infected with the
intestinal tapeworm stage of the infection (T. solium) will shed
tapeworm eggs in their bowel movements. Tapeworm eggs that are
accidentally swallowed by another person can cause infection.
Should I be tested for an
intestinal tapeworm infection?
Yes. Family members may
also be tested. Because the tapeworm infection can be difficult to
diagnose, your health care provider may ask you to submit several stool
specimens over several days or to examine your stools for evidence of a
tapeworm.
How can I prevent cysticercosis
and other disease causing germs?
- Avoid eating raw or
undercooked pork and other meats.
- Don’t eat meat of
pigs that are likely to be infected with the tapeworm.
- Wash hands with soap
and water after using the toilet and before handling food, especially
when traveling in developing countries.
- Wash and peel all
raw vegetables and fruits before eating. Avoid food that may be
contaminated with feces.
- Drink only bottled
or boiled (1 minute) water or carbonated (bubbly) drinks in cans or
bottles. Do not drink fountain drinks or any drinks with ice cubes.
Another way to make water safe is by filtering it through an
"absolute 1 micron or less" filter AND dissolving iodine
tablets in the filtered water. "Absolute 1 micron" filters
can be found in camping/outdoor supply stores.
For more information:
- Del Brutto OH, Rajshekhar
V, White AC, Tsang VCW, Nash TE, Takayanugi OM, Schantz PM, Evans CAW,
Flisser A, Correa D, Boero OD, Allan JC, Sarti E, Gonzalez AE, Gilman
RH, Garcia HH. Proposed diagnostic
criteria for neurocysticcercosis. Neurol 2001; 57: 177-183.
- Garcia HH, Evans CAW, Nash
TE, Takayanagui O, White AC, Botero DV, Tsang VCW, Schantz P, Allan
J, Flisser A, Correra D, Sarti E, Friedland J, Martinez SM, Gonzalez
AE, Gilman RH, Del Brutto OH. Consesus:
Current Guidelines for the Treatment of Neurocysticercosis. Clin Microbiol Rev 2003; 15:747-56.
- Schantz PM, Taenia solium
Cysticercosis: an Overview of
Gobal Distribution and Transmission. Chapter in Taenia solium Cysticercosis. From Basic to Clinical Science,
CABI Publishing, 2002, pp. 63-74.
- Shandera WX, Schantz PM, White
AC. Taenia solium cysticercosis:
The special case of the United States. Chapter in Taenia solium
Cysticercosis. From Basic to Clinical Science, CABI Publishing,
2002, pp. 139-144.
This fact sheet is for
information only and is not meant to be used for self-diagnosis or as a
substitute for consultation with a health care provider. If you have any
questions about the disease described above or think that you may have a
parasitic infection, consult a health care provider.
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