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Cysticercosis
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Cysticercosis

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Contributors: Edith Lederman MD, Noah Craft MD, PhD, Art Papier MD, William Van Stoecker MD
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Synopsis

Cysticercosis refers to infection with the larval stage of the pork tapeworm, Taenia solium. Taenia solium may also cause taeniasis (infestation of the small bowel with an adult worm). The larval form is sometimes referred to as Cysticercus cellulosae. Humans usually acquire cysticercosis via fecal-oral transmission of T solium eggs from tapeworm carriers via contaminated food or water. Once in the small intestine, the ingested eggs hatch and penetrate the mucosa. The embryos then spread hematogenously throughout the body and encyst in various locations. The most frequently affected sites are skeletal muscle, subcutaneous tissue, the heart, the central nervous system (CNS), and ocular structures.

Subcutaneous cysticercosis primarily manifests as multiple freely mobile nodules. Its primary significance is as an indicator of possible neurocysticercosis. Cysticerci may also invade skeletal muscle, giving rise to myositis (fever, myalgias, eosinophilia) and sometimes pseudohypertrophy. Intraocular cysticercosis may lead to vision loss.

Neurocysticercosis is the most serious manifestation of cysticercosis and is the most common cause of acquired epilepsy worldwide. In addition to seizures, the presence of cysticerci in the brain may lead to stroke, meningitis / encephalitis, increased intracranial pressure, focal neurologic deficits, dementia, or death. Neurocysticercosis may also be asymptomatic. After 5-10 years, however, the cysts eventually degenerate, and it is the intense inflammatory response to these degenerating cysts that cause the majority of symptoms. Patients often experience long-term sequelae such as seizures.

Cysticercosis is endemic to Mexico and Latin America, Eastern Europe, sub-Saharan Africa, Indonesia, China, and southeastern Asia. The incidence of this important parasitic disease is rising in the United States, especially in California and other states with a large immigrant population. In a nationwide study examining hospitalization frequency for neurocysticercosis in the United States between 2003-2012, Hispanic individuals were at the highest risk, in particular males 20-44 years of age.

Codes

ICD10CM:
B69.9 – Cysticercosis, unspecified

SNOMEDCT:
59051007 – Cysticercosis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Skin lesions:
Clinical manifestations of neurocysticercosis:
Lesions on brain imaging may resemble:

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 09/30/2019
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Cysticercosis
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Cysticercosis : Abdominal pain, Blurred vision, Diarrhea, Seizures, Headache, Nausea, Paresthesias, Subcutaneous nodules
Clinical image of Cysticercosis
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