Contents

Parasitic disease due to infection with tapeworms belonging to the genus Taenia.

Epidemiology

Life cycle:

Principal intermediate hosts:
- Taenia solium (pork tapeworm)
- Taenia saginata (beef tapeworm)
Man is the only definitive host for both

Aetiology

Food or drinking water contaminated by tapeworm eggs from human feces

Taeniasis
Most infections with adult worms (Taeniasis) are asymptomatic

If symptomatic (severe infections), nonspecific complaints:
- Nausea
- Pain in abdomen
- Diarrhoea

Cysticercosis
Carriers have an increased risk of developing cysticercosis by repeated autoinfection.

Common target organs:
- Brain
- Muscle
- Subcutaneous tissue
Clinical manifestations depend on the location, number and size of cysts in the brain and host inflammatory response.
- Viable cysts generally do not elicit a strong response
- On the other hand, degenerating cysts provoke a vigorous host response.

Neurocysticercosis
M/C parasitic infection of the CNS

Stool examination:

Demonstration of eggs or proglottids
- Patients may pass motile segments of worms through anus

CSF examination:

Enzyme-linked immunotransfer blot (EITB):
90% sensitivity & specificity

CT and MRI (brain):
Diagnostic

Anti-cysticercosis medications:
- Niclosamide
- Praziquantel
Steroids (2-3 days before and during treatment)
- During treatment, dying parasities can provoke severe life-threatening inflammatory response which can be prevented by giving steroids

Neurocysticercosis

Observation
Anticonvulsant medication
- Children having seizures and calcified, inactive lesions on CT do not require specific therapy, apart from anticonvulsants.
Antiparasitic drugs
Surgery
Anti-cysticercal drugs:
- Albendazole and praziquantel
- Contraindicated for spinal or ocular disease as drug-induced inflammation may produce irreversible organ damage
  - These lesions, as well as those within the ventricular system, are best managed surgically.