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Neurocysticercosis responsible for significant disease in urban setting
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WASHINGTON, D.C. — Data from 72 consecutive patients affected with neurocysticercosis during a large outbreak of the disease in New York indicate that the infection can cause significant disease, even in an urban setting, according to a presentation here at ICAAC 2014.
According to the CDC, the parasitic infection is caused by the larvae of the pork tapeworm, Taenia solium. It is common in Latin America and is a leading cause of adult-onset epilepsy throughout the world.
“Large case series of neurocysticercosis have been described among immigrant populations in several US cities,” Siddhi Mankame, MD, of Jacobi Medical Center in Bronx, N.Y., and colleagues wrote. “This is the largest series of neurocysticercosis in New York and highlights the morbidity associated with extraparenchymal disease.”
Neurocysticercosis is a parasitic infection that is caused by the larval form pork tapeworm, T. solium, according to the researchers.
Mankame and colleagues reviewed the clinical charts of the 72 patients who presented with the disease to Jacobi Medical Center’s Tropical Medicine Clinic. Almost all of the patients (97.2%) were immigrants from 12 countries, the most common being Mexico, Ecuador and Guatemala. The median time from immigration to presentation in the clinic was 8 years. Two patients were US-born and one of those was a traveler.
Thirty-seven patients (51.4%) had parenchymal neurocysticercosis; 16 had viable cysts, and 22 had calcified parenchymal disease. Most of the patients (83.8%) with parenchymal disease presented with seizures. Among the patients with calcified disease, 15 had perilesional edema on MRI and among those, 14 of those presented with seizures and one presented with headache.
Among the patients with extraparenchymal disease, nine patients had intraventricular disease; seven in the fourth ventricle. Thirty-one patients had subarachnoid neurocysticercosis; 19 in the basilar cistern, 17 in the sylvian fissure. Seven of those patients had concurrent spinal disease. Five patients with subarachnoid neurocysticercosis experienced vascular events, including four cerebrovascular accidents, two transient ischemic attacks and one subarachnoid hemorrhage.
“Patients with extraparenchymal neurocysticercosis presented with elevated pressure inside the brain and stroke-like events, whereas seizures were the most common manifestation for those with parenchymal disease,” the researchers wrote. “Shunts were places in 20 patients and were more likely to be required in patients with extraparenchymal neurocysticercosis.”
For more information:
Mankame S. Abstract P-1280. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.
Disclosure: The researchers report no relevant disclosures.