Human cysticercosis: a probable case of cerebral cysticercosis with generalized subcutaneous nodular lesions

Cysticercosis in Nepal: a histopathologic study of sixty-two cases

Human cysticercosis, an infection caused by larvae of Taenia solium, is a major public health problem in many developing countries. Sixty-two of 23,402 biopsy cases have been detected as cysticercosis in the last 5 years in Patan Hospital. Most (82%) of the patients presented with solitary skin nodules, another 10% with nodules in the oral mucosa, and 8% in the breast. Forty cases were identified from the Kathmandu valley and the rest from outside Kathmandu. Most patients were younger than 30 years of age (mean, 21+/-11 years). Statistically, there was no difference between males (0.28%) and females (0.24%). The average size of cysticercosis was 19 mm in diameter, and the histology of cysticercosis showed fibrous walled cysts covered by several layered epithelioid cells with a few Langhans' giant cells and infiltration of eosinophils without caseous necrosis. These cysticercosis findings from an endemic area will be helpful for doctors who examine immigrant patients in nonendemic areas.

Subcutaneous cysticercosis

A case of subcutaneous cysticercosis is presented, and 35 other cases from the literature are reviewed. Patients usually have multiple subcutaneous nodules that are firm, mobile, and sometimes painful, occurring mainly on the trunk and extremities. Diagnosis is made by biopsy; however, radiologic and immunologic studies can be helpful in the diagnosis and work-up. Treatment options include surgery, praziquantel, and albendazole.

Cysticercus racemosus in an eosinophilic phlegmon in the brain

Cysticercus racemosus in a tumour-like mass from the brain of a 30-year-old Canadian was identified by histological and specific immunofluorescent techniques. The patient possibly acquired the infection during her stay in India. She had a mild peripheral eosinophilia and complained of pounding headaches and convulsions. Examination of tissue sections revealed the larva enclosed in an eosinophilic phlegmon and the surrounding brain tissue infiltrated by histiocytes and eosinophils. Loss of microtriches and degenerative changes in the larva were apparent in areas with adherent eosinophils. With the appropriate reagents, both intracellular and interstitial specific immune complexes were detected in the biopsied tissue. The course of infection in the cystic and racemosus types of cysticercosis and the role of tissue eosinophilia in neurocysticercosis have been discussed.