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Cysticercosis
Last reviewed: 05.07.2025
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Cysticercosis (Latin: cysticercosis) is a chronic biohelminthiasis caused by the larval stage of the pork tapeworm - cysticercus (Finns).
ICD-10 codes
- B69. Cysticercosis.
- B69.0. Cysticercosis of the central nervous system.
- B69.1. Cysticercosis of the eye.
- B69.8. Cysticercosis of other localizations.
- B69.9. Cysticercosis, unspecified.
Epidemiology of cysticercosis
Cysticercosis in humans develops after infection with oncospheres by the fecal-oral route or as a result of autoinvasion in the presence of intestinal taeniasis, when mature segments are thrown from the intestine into the stomach due to antiperistaltic contractions. Cysticercosis, like intestinal taeniasis, is registered in countries where pig farming is developed.
What causes cysticercosis?
Cysticercosis is caused by Cysticercus cellulosae (larval stage of Taenia solium) and is a vesicle-shaped formation 5-15 mm in diameter containing an inverted scolex.
Pathogenesis of cysticercosis
Parasitism of Cysticercus cellulosae is most often observed in the subcutaneous tissue, brain and spinal cord, eyes, muscles, heart, liver, lungs, peritoneum, etc. A reactive connective tissue capsule forms around the helminth in all organs and tissues (except the eye), inflammatory and degenerative changes develop. The significance of the factor of mechanical compression of surrounding tissues by parasites depends on the localization of cysticerci. Severe consequences result from the introduction into the brain and eyes. Vasculitis, pronounced glial reaction, possible encephalitis, meningitis, and impaired cerebrospinal fluid dynamics develop in the brain tissue around the cysticercus. When the larva is localized in the membranes of the base of the brain, a racemose (branched) form of cysticercus develops, and the parasite, reaching a length of more than 20 cm, can descend along the spinal cord. When the eyes are affected, both eyes are often involved in the process. Expressed toxic-allergic reactions are observed when the parasite dies, when it melts; during calcification, there is no inflammatory reaction.
Symptoms of Cysticercosis
Symptoms of cysticercosis are very diverse and are determined by its location, the intensity of the invasion and the stage of development of the parasite.
Cysticercosis of the subcutaneous tissue and muscles often has no obvious signs, sometimes dense nodules are palpated in the tissues. Cysticercosis of the central nervous system occurs in the form of cerebral, spinal lesions or combined lesions of the cerebral hemispheres, ventricular system, base of the brain, therefore the developing symptoms of cysticercosis are very diverse. Paroxysmal headaches are characteristic, accompanied by nausea, vomiting, epileptic seizures. Mental disorders in the form of delirious, hallucinatory and amentive states, which are transient up to a certain time, are possible. When cysticerci are localized in the ventricles of the brain, intracranial hypertension is detected; localization of the parasite in the fourth ventricle can lead to sudden death. Cysticercosis of the eye initially manifests itself in visual impairment, decreased visual acuity, up to blindness. The introduction of a cysticercus into the eye socket causes exophthalmos. Its localization in the heart in the area of the atrioventricular bundle leads to disturbances in the heart rhythm.
Diagnosis of cysticercosis
Subcutaneous localization of the parasite is registered in approximately 50% of patients with cysticercosis. The diagnosis of "cysticercosis" in this case is established on the basis of an X-ray or the results of a biopsy of the nodes. Cysticercosis of the brain is diagnosed on the basis of anamnestic (including the disease taeniasis), clinical and epidemiological data, positive results of serological studies (ELISA, etc.), however, it should be borne in mind that sometimes cross-reactions are noted in the presence of other invasions.
In case of brain damage, pleocytosis with a predominance of eosinophils and lymphocytes and an increase in protein concentration are possible in the cerebrospinal fluid.
CT, MRI, and cerebral angiography are used to identify brain lesions.
Detection of intraocular cysticercus is possible with direct ophthalmoscopy and biomicroscopy, when wave-like movements of a living parasite are visible. When the pathogen dies, diagnosis of cysticercosis is difficult due to disorganization of intraocular structures.
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Differential diagnosis of cysticercosis
Differential diagnosis of cysticercosis is carried out with tumors and inflammatory diseases of organs, echinococcosis.
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Indications for consultation with other specialists
Consultations with other specialists (neurosurgeon, ophthalmologist, surgeon) are used to perform surgical treatment of cysticercosis.
Indications for hospitalization
Patients with neurocysticercosis and ocular cysticercosis are hospitalized in specialized hospitals for examination and treatment.
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Treatment of cysticercosis
Antiparasitic treatment of cysticercosis is carried out with praziquantel at a daily dose of 50 mg/kg of body weight per day in three doses for 14 days or more or albendal at 15 mg/kg of body weight per day in three doses for 28 days. It is recommended to carry out three treatment cycles with an interval of 2-3 weeks.
Along with the use of anthelmintic drugs, anti-inflammatory treatment of cysticercosis is carried out and glucocorticoids are prescribed.
Patients with cysticercosis of muscles and subcutaneous tissue are prescribed symptomatic treatment.
Surgical removal of single cysticerci (if technically possible) is indicated for lesions of the eyes, ventricles of the brain and spinal cord.
Prognosis for cysticercosis
The prognosis depends on the topography and extent of tissue and organ damage.
Cysticercosis of the brain (especially with multifocal lesions of its various parts) and eyes have an unfavorable prognosis. Patients with such lesions require long-term (almost lifelong) observation and treatment.