Clinical, epidemiological and laboratory criteria for the diagnosis of human cysticercosis in Brazilian patients

Abstract

Cysticercosis (CC) is a polymorphous disease, which makes its diagnosis difficult. This study had the objective of evaluating the clinical, epidemiological and laboratory criteria in human CC. An epidemiological questionnaire was applied, and indirect fluorescence antibody test (IFAT) and ELISA-IgG were utilized together with computerized tomography and/or magnetic resonance imaging on 90 patients with clinical signs suggestive of neurocysticercosis (NCC). Most patients had previously lived under deficient basic sanitary conditions. The imaging techniques showed that 92.2% of the cysticerci were in the cerebral parenchyma, 5.5% had a ventricular location, 1.1% were periventricular and 1% was ocular. The cysticerci were observed to be predominantly in the inactive phase. Seropositivity to the IFAT and/or ELISA was shown by 32.2% (29/90). Of the 29 seropositive patients, 72.4% presented cysticerci in the inactive form, and of the 61 seronegative patients, 78.7% also presented cysticerci in the inactive form. There was no correlation between active CC and seropositivity, since 72.4% of the seropositive patients presented calcified cysticerci. The results demonstrated that imaging techniques contributed significantly to elucidate the laboratorial diagnosis and to evaluate the stage of cysticercus development.