Human cysticercosis is acquired by ingesting T. solium tapeworm ova, from either contaminated fingers or food. The larvae are liberated from eggs in the stomach, penetrate the intestinal mucosa and are carried to many parts of the body, where they develop and form cysticerci, 0.5–1 cm cysts that contain the head of a young worm. They do not grow further or migrate.
Common locations are the subcutaneous tissue, skeletal muscles and brain.
When superficially placed, cysts can be palpated under the skin or mucosa as pea-like ovoid bodies. Here they cause few or no symptoms, and will eventually die and become calcified.
Heavy brain infections, especially in children, may cause features of encephalitis. More commonly, however, cerebral signs do not occur until the larvae die, 5–20 years later. Epilepsy, personality changes, staggering gait or signs of hydrocephalus are the most common features.
Calcified cysts in muscles can be recognized radiologically. In the brain, however, less calcification takes place and larvae are only occasionally visible by plain X-ray; usually CT or MRI will show them. Epileptic fits starting in adult life suggest the possibility of cysticercosis if the patient has lived in or travelled to an endemic area. The subcutaneous tissue should be palpated and any nodule excised for histology. Radiological examination of the skeletal muscles may be helpful. Antibody detection is available for serodiagnosis.
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