Cysticercosis

This dmg was used prior to the availabiUty of niclosamide and is considered less satisfactory for the treatment of tapeworms than niclosamide (24). It causes more side effects and produces severe nausea. Quinacrine, however, is preferred by some clinicians for the treatment of Taenia solium infection because, unlike niclosamide, it expels the worms intact, thus reducing the theoretical risk of cysticercosis (25). 

Taenia solium Cysticercosis pork tapeworm disease... 

For nearly 80% of patients with epilepsy, the underlying etiology is unknown.8 The most common recognized causes of epilepsy are head trauma and stroke. Developmental and genetic defects are the cause of about 5% of cases of epilepsy. Central nervous system (CNS) tumors, central nervous system infections, and neurodegen-erative diseases are other common causes. Other important causes of epilepsy are human immunodeficiency virus infection or neuro-cysticercosis infection, primarily occurring in Latin America. 

Tapeworm infections (T. saginata and T. solium) are treated with praziquantel 5 to 10 mg/kg as a single dose (use the same dose for adults and pediatric patients).3 The treatment for cysticercosis and neurocysticercosis may include surgery, anticonvulsants (neurocysticercosis can cause seizures), and anthelmintic therapy. The anthelmintic therapy of choice is albendazole 400 mg twice daily for 8 to 30 days. The pediatric dose of albendazole is 15 mg/kg (maximum 800 mg) in two divided doses for 8 to 30 days. The doses for both adults and pediatric subjects can be repeated if necessary. Praziquantel is an alternative therapy.3... 

The most serious complication of cysticercosis is neurocys-ticercosis that can cause strokes and seizures. Treatment of neurocysticercosis with anthelmintic treatment remains controversial. 

Suggested Alternatives for Differential Diagnosis Bartonellosis, brucellosis, other causes of encephalitis, coxsackieviruses, cryptococcosis, cysticercosis, cytomegalovirus, histoplasmosis, legionellosis, leptospirosis, listeria, lyme disease, malaria, rabies, tuberculosis, mumps, stroke, metabolic encephalopathy, Reye syndrome, Bartonella infection, Naegleria infection, Ebstein-Barr virus, prion disease, toxic ingestions, and AIDS. 

In presence of cysticercosis, drug mayproduce retinal damage in presence of retinal... 

Unlabeled Uses Asthma, chemotherapy-induced stomatitis, dermographia, familial immunodeficiency disease, malaria, mastocytosis, Meniere s disease, nausea, neuro-cysticercosis, otitis media, psoriasis, radiocontrast media reactions, urticaria... 

Contraindications Ocular cysticercosis, hypersensitivity to praziquantel or any component of the formulation... 

Albendazole (9.117), a benzimidazole carbamate, is a broad-spectrum oral antihelminthic used for cysticercosis, ascariasis, pinworm infestation, and hookworm infestation. It is thought to work by blocking microtubule synthesis in the nematode, subsequently impairing glucose uptake. 

Cysticercosis (pork tapeworm larval stage) Albendazole Praziquantel... 

Albendazole, a broad-spectrum oral antihelminthic, is the drug of choice and is approved in the USA for treatment of hydatid disease and cysticercosis. It is also used in the treatment of pinworm and hookworm infections, ascariasis, trichuriasis, and strongyloidiasis. 

Benzimidazoles are thought to act against nematodes by inhibiting microtubule synthesis. Albendazole also has larvicidal effects in hydatid disease, cysticercosis, ascariasis, and hookworm infection and ovicidal effects in ascariasis, ancylostomiasis, and trichuriasis. 

A single 2 g dose of niclosamide results in cure rates of over 85% for D latum and about 95% for T saginata. It is probably equally effective against T solium. Cysticercosis can theoretically occur after treatment of T solium infections, because viable ova are released into the gut lumen after digestion of segments, but no such cases have been reported. 

Most patients treated with niclosamide for H diminuta and Dipylidium caninum infections are cured with a 7-day course of treatment a few require a second course. Praziquantel is superior for Hymenolepis (dwarf tapeworm) infection. Niclosamide is not effective against cysticercosis or hydatid disease. 

Praziquantel is effective in the treatment of schistosome infections of all species and most other trematode and cestode infections, including cysticercosis. The drug s safety and effectiveness as a single oral dose have also made it useful in mass treatment of several infections. 

A single dose of praziquantel, 5-10 mg/kg, results in nearly 100% cure rates for Tsaginata, Tsolium, and D latum infections. Because praziquantel does not kill eggs, it is theoretically possible that larvae of T solium released from eggs in the large bowel could penetrate the intestinal wall and give rise to cysticercosis, but this hazard is probably minimal. 

Note Albendazole is approved in the USA for the treatment of cysticercosis and hydatid disease. 

Garcia HH et al A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 2004 350 249. [PMID 14724304]... 

Mathis, A. and Deplazes, P. (2002) Role of PCR-DNA detection of Echinococcus multilocularis. In Craig, P. and Pawlowski, Z. (eds) Cestode Zoonoses Echinococcosis and Cysticercosis. IOS Press, Amsterdam, pp. 195-204. 

One parenteral cestode that is widely accepted as a model for cysticercosis caused by T. solium in humans is Taenia crassiceps, which is found as an adult in foxes and has a rodent intermediate host. Larval T. crassiceps reproduce by budding in the peritoneal cavity of mice and can be serially transferred from mouse to mouse. The immune response, which controls larval growth, relies on T cell-mediated immune mechanisms (Lopez-Briones et al., 2001) and treatments resulting in increased delayed type hypersensitivity led to greater resistance, while AB production was unaffected (Bojalil eta/., 1993). 

Bojalil, R., Terrazas, L.I., Covezensky, T., Sciutto, E. and Larralde, C. (1 993) Thymus-related cellular immune mechanisms in sex-associated resistance to experimental murine cysticercosis (Taenia crassiceps). Journal of Parasitology 79, 384-389. 

Londono, D.P., Alvarez, J.I., Trujillo, J., Jaramillo, M.M. and Restrepo, B.l. (2002) The inflammatory cell infiltrates in porcine cysticercosis immunohistochemical analysis during various stages of infection. Veterinary Parasitology 109, 249-259. 

Lopez-Briones, S., Soloski, M.J., Bojalil, R., Fragoso, G. and Sciutto, E. (2001) CD4+TCRa(iT cells are critically involved in the control of experimental murine cysticercosis in C57BL/6J mice. Parasitology... 

Morales-Montor, J., Hallal-Calleros, C., Romano, M.C. and Damian, R.T. (2002) Inhibition of P-450 aro-matase prevents feminisation and induces protection during cysticercosis. International Journal for Parasitology 32, 1 379-1 387. 

Rajshekhar, V., Joshi, D.D., Doanh, N.Q., van De, N. and Xiaonong, Z. (2003) Taenia solium/cysticercosis in Asia epidemiology, impact and issues. Acta Tropica 87, 53-60. 

Rickard, M.D. and Williams, J.F. (1982) Hydatidosis/cysticercosis immune mechanisms and immunization against infection. Advances in Parasitology 21, 229-296. 

Spolski, R.J., Alexander-Miller, M.A. and Kuhn, R.E. (2002a) Suppressed cytotoxicT lymphocyte responses in experimental cysticercosis. Veterinary Parasitology 106, 325-330. 

Toenjes, S.A. and Kuhn, R.E. (2003) The initial immune response during experimental cysticercosis is of the mixed Thl /Th2 type. Parasitology Research 89, 407-413. 

Garcia, H.H., Gonzales, A.E., Evans, A.C, Gilman, R.H. and Cysticercosis working group in Peru (2003) Taenia solium cysticercosis. Lancet 362, 547-556. 

Time-response curve of oxfendazole in the treatment of swine cysticercosis. American Journal of Tropical Medicine and Hygiene 59, 832-836. 

Sarti, E., Schantz, P.M., Avila, G., Ambrosio, J., Medina-Santillan, R. and Flisser, A. (2000) Mass treatment against human taeniasis for the control of cysticercosis a population-based intervention study. Transactions of the Royal Society of Tropical Medicine and Hygiene 94, 85-89. 

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