Cysticercosis B69.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Cysticercosis; Fin Disease; Skin cysticercosis

History
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Tyson, 1683; Hartmann, 1685; Malpighi, 1698; Goeze, 1784; chef, 1855

Definition
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Disease caused by fins (especially of the porcine tapeworm).

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Dermatology

Dyskeratosis follicularis

Rare, genetically determined, chronic progressive or chronic relapsing, diffuse or localized, also segmenta...

Pathogen
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Taenia solium, taenia saginata

Etiopathogenesis
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Oral uptake of the eggs of Taenia solium, rarely Taenia saginata. Also autoinfection by regurgitation with washout of the eggs into the stomach. Pig or cattle are the natural reservoir of the pathogen, humans act as intermediate hosts. The fins penetrate the intestinal wall and disseminate into various organs, mainly into the muscles, but also into the eyes, CNS, cutis and subcutis. S.a. Echinococcosis.

Clinical features
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Fleeting allergic phenomena. Skin lesions: Indolent, pea-sized to hazelnut-sized, roundish-oval, smooth, consistent, easily movable, cutaneous and subcutaneous nodules, especially on the upper half of the body.

Diagnosis
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X-ray: Calcified fins after 3-5 years
Liquor puncture and computer tomography with mainly CNS involvement
ELISA (70-80% sensitivity) or EITB (Enzyme-Linked Immunoelectrotransfer-Blot; sensitivity 90-95%)
Histology (fin detection)

Internal therapy
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Praziquantel (e.g. Cesol) 50 mg/day p.o. in 3 ED over 14 days with plenty of liquid.
Alternatively: Albendazole (e.g. Eskazole) 15 mg/kg bw/day p.o. for 28 days.
If necessary, interception of the accompanying symptoms by additional administration of glucocorticoids such as prednisone (e.g. Decortin) 40 mg/day with gradual dose reduction.
In case of neurological involvement or eye infestation, consult the relevant disciplines at an early stage.

Prophylaxis
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Abstention from eating raw meat.

Literature
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Engels D et al (2003) The control of human (neuro) cysticercosis: which way forward? Acta Trop 87: 177-182
Garcia HH et al (2003) Taenia solium cysticercosis. Lancet 362: 547-556
Goeze JAE (1784) Latest discovery that the fins in pork are not a drusen disease but true bladder worms. Plate, Hall, p. 1-40
Nash TE et al (2003) Human case management and treatment of cysticercosis. Acta Trop 87: 61-69
Hartmann (Hartmannus) PJ (1685) Miscellanea curiosa sive Ephemeridum Medico-Physicarum Germanicarum Academiae Imperialis Leopoldinae Naturae Curiosorum Decuriae II. AnnusQuartus, Anni MDCLXXXV Observatorio LXXIII Joannis Ernesti Adelbulneri, Nuremberg pp. 152-157
Küchenmeister F (1855) Experimental proof that Cysticercus cellulosae within the human Damar canal turns into Taenia solium. Vienna Med Weekly 5: 1-4
Malpighi M (1698) Opera posthumous. Quibus praefixa est vita, a seipso scripta. A. & J Churchill, London
Rajshekhar V et al (2003) Taenia solium taeniosis/cysticercosis in Asia: epidemiology, impact and issues. Acta Trop 87: 53-60
Roth B et al (2003) Cysticercosis as a rare cause of a tumor of the tongue. Laryngorhinootology 82: 564-567
Schantz PM et al (2003) The US Centers for Disease Control and Prevention (CDC) and research and control of cysticercosis. Acta Trop 87: 161-163
Tyson E (1683) Lumbricus teres, or some anatomical observations on the round worm bred in human bodies Philos Trans R Soc (London) 13: 153-161
Walrath JD et al (2003) Cysticercosis isolated to the orbit. Ophthal Plast Reconstr Surg 19: 243-244