Cysticercosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Cysticercosis is treated easily with antihelminthic drugs and even untreated patients can remain silent for long periods. Complications can develop in the intestine if the tapeworm grows enough to cause obstructions or at the sites of cysticerci when they start to degenerate and provoke the immune system.
Natural History
Most of the cases remain asymptomatic for long periods. Symptoms and signs arise in some patients with cyst degeneration and subsequent provocation of the immune system.
Complications
Intestinal Tapeworm infection
Tapeworm can grow inside the digestive tract and reach a length of 30 feet. It can cause obstruction at various sites in the GIT as:
CNS cysticercosis
- Seizures
- Neurological deficits
- Hydrocephalus (80%)[1]
- Cerebral infarcts (64%)
- Mental disorders (43%)
Ocular cysticercosis
Cysticerci can be located anywhere in the orbit: in the retina, subretinal space, vitreous, anterior chamber or even in the extraocular muscles. Many patients go asymptomatic while others may have:
- Chorioretinitis
- Retinal detachment
- Blindness in advanced cases after 3-5 years[2]
Prognosis
- Prognosis differs from patient to patient and depends on the site and number of cysts.
- On neuroimaging, single ring enhancing lesion is associated with better prognosis.[3]
- Retinal and subretinal infestation have the worst prognosis and are the most difficult to treat.
- In 13 years (1990 - 2001), deaths from cysticercosis in the united states were 221 cases.[4]
- The greater majority of the cases were Latinos followed by whites .. The ethnicity of the cases were as the following:
- Latinos: 84.6%
- White: 6.8%
- Blacks: 5.9%
- Asian: 2.3%
- Native American: 0.5%
References
- ↑ Cantú C, Barinagarrementeria F (1996). "Cerebrovascular complications of neurocysticercosis. Clinical and neuroimaging spectrum". Arch. Neurol. 53 (3): 233–9. PMID 8651876.
- ↑ Sharma T, Sinha S, Shah N, Gopal L, Shanmugam MP, Bhende P, Bhende M, Shetty NS, Agrawal R, Deshpande D, Biswas J, Sukumar B (2003). "Intraocular cysticercosis: clinical characteristics and visual outcome after vitreoretinal surgery". Ophthalmology. 110 (5): 996–1004. doi:10.1016/S0161-6420(03)00096-4. PMID 12750103.
- ↑ Piovesana P, Corrado D, Verlato R, Lafisca N, Mantovani E, DiMarco A, Pantaleoni A (1989). "Morbidity associated with anomalous origin of the left circumflex coronary artery from the right aortic sinus". Am. J. Cardiol. 63 (11): 762–3. PMID 2923067.
- ↑ Sorvillo FJ, DeGiorgio C, Waterman SH (2007). "Deaths from cysticercosis, United States". Emerging Infect. Dis. 13 (2): 230–5. doi:10.3201/eid1302.060527. PMC 2725874. PMID 17479884.