Neurocysticercosis Diagnosed in a Patient with Taenia saginata Taeniasis after Administration of Praziquantel: A Case Study and Review of the Literature

Abstract

IntroductionTaeniasis/cysticercosis, caused by the pork tapeworm, Taenia solium, is a parasitic zoonosis found primarily in countries where pigs are raised and meat inspection is lacking [1,2]. The potential for a tapeworm carrier to infect another individual (or themselves via autoinfection), resulting in cysticercosis or neurocysticercosis (NCC), is a risk not only in endemic areas, but also in areas with immigrants from endemic countries [1,[3][4][5]]. An example of such an outbreak occurred in an Orthodox Jewish community in New York City when family members were infected by a domestic employee from a T. solium endemic country [6]. Such NCC outbreaks have occurred in other developed countries, including countries in the Middle East where people do not consume pork [4,5,[7][8][9][10][11][12][13].In Asia, there are three Taenia tapeworms that infect humans; T. solium, Taenia saginata and Taenia asiatica [4,5,[14][15][16][17][18][19][20][21][22][23][24]. Although adult T. solium worms with scoleces are easily differentiated morphologically from other taeniids, it is almost impossible to differentiate adult T. asiatica and T. saginata [5,22,25,26]. Therefore, molecular differentiation is often required to correctly identify the infecting species [27]. Recent studies have also reported hybrids of T. saginata and T. asiatica in Thailand and China [5,25,[28][29][30][31][32]. This makes mitochondrial and nuclear gene analyses even more important for the differentiation of T. saginata, T. asiatica, and hybrids of these two species [30][31][32].In Indonesia, T. solium, T. saginata and T. asiatica are distributed according to livestock rearing and local food consumption practices [33][34][35][36][37][38][39][40]. Both T. saginata and T. solium have been confirmed from the island of Bali, where the local inhabitants are known to eat dishes that contain undercooked beef and pork, such as the traditional dish Lawar. NCC was considered endemic on Bali more than 20 years ago [41,42]. However, education programs aimed at keeping pigs indoors to prevent access to human faeces and the introduction of improved sanitation systems and practices have substantially reduced the prevalence of NCC during the past 2 decades [35,37,43]. Nevertheless, there are still sporadic NCC cases identified on Bali [40,[42][43][44][45]. Case ReportFieldwork conducted on Bali from 2002-2007 resulted in the identification of 69 taeniasis carriers who were treated with a single dose of praziquantel (PZQ) at 15 mg/kg body weight (Table 1). All worms were confirmed to be T. saginata by multiplex PCR [36]. In August 2007, a 47-year-old male taeniasis carrier from the Gianyar district suffered a single tonic-clonic seizure within a few hours of PZQ administration. The patient was subsequently admitted to the Sanglah Hospital in Denpasar. A computed tomography (CT) scan revealed one viable cystic lesion and one calcified lesion in the right frontal lobe of the brain. At this time, serology (ELISA) was also carried out using partially purified antigens by c...

Seroepidemiology of Taeniasis in the Land of Papua

“…The above districts were chosen for their high prevalence of cysticercosis among pigs, which could have an impact on the transmission of T.solium tapeworms to humans. Taeniasis and cysticercosis transmission in Papua was first reported in 1972 where H. nana tapeworm Taeniasis is closely related to community's sociocultural factors and habits, including not keeping livestock inside pens, eating undercooked beef and pork, unhealthy eating habits and lack of knowledge on environmental sanitation (Estuningsih, 2009) (Wandra et al, 2016) (Wandra et al, 2015).…”

Systematic review of the effectiveness of selected drugs for preventive chemotherapy for Taenia solium taeniasis

“…It is important to note that there were two reports of neurological side-effects following PZQ 5mg/kg, including severe headaches in one case of undiagnosed neurocysticercosis [13] and another case of seizures that the authors suggest may not have been directly related to the treatment [37]. These reports, along with 2-3 other case reports of neurological side-effects following administration of PZQ for Taenia saginata and/ or Hymenolepis nana [75][76][77] have led to some concern about the safety of PZQ in areas endemic for cysticercosis. However, perspective is warranted here as case reports are a very low level of evidence of effect and chance cannot be ruled out.…”

Co-occurrence of swine cysticercosis due toTaenia soliumandTaenia hydatigenain ethnic minority villages at the Thai–Myanmar border

“…There have been many serological reports on swine cysticercosis in endemic areas, but most were based only on serology, without direct evidence of parasitic infection from necropsy confirmation (Dorny et al ., 2004; Krecek et al ., 2008; Deckers and Dorny, 2010; McCleery et al ., 2015; Dermauw et al ., 2016; Kungu et al ., 2017). Furthermore, most studies on swine cysticercosis have ignored the notable factor of pigs and dogs typically being free roaming in endemic areas, therefore those pigs are frequently coinfected with both T. solium and T. hydatigena (Ito, 2013; Swastika et al ., 2016). Thus, an evaluation of the endemic area environment must be prerequisite for any field work on swine cysticercosis.…”

“…Neurocysticercosis (NCC) is potentially one of the most lethal parasitic zoonoses spreading worldwide. However, most NCC cases are asymptomatic until the parasite becomes damaged by the host defence mechanisms (Schantz et al ., 1998; Garcia et al ., 2016; Pawlowski, 2016; Wandra et al ., 2016; WHO, 2016).…”

“…Eggs from an adult tapeworm in the human intestine can cause NCC either in the tapeworm-carriers themselves or in other people who have some intimate contact with the tapeworm-carriers (Schantz et al ., 1998; Kobayashi et al ., 2013; Ito and Budke, 2014; Pawlowski, 2016; Davaasuren et al ., 2017). One highly endemic area for this parasite is Asia, including Thailand (Ito et al ., 2003, 2014, 2016; Li et al ., 2006, 2007; Anantaphruti et al ., 2007, 2010; Kobayashi et al ., 2013; Ito and Budke, 2014; McCleery et al ., 2015; Wandra et al ., 2016; Davaasuren et al ., 2017; Wu et al ., 2017; Sato et al ., 2018).…”