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Fan S, Qiao X, Liu L, Wu H, Zhou J, Sun R, Chen Q, Huang Y, Mao C, Yuan J, Lu Q, Ge Y, Li Y, Ren H, Wang J, Cui L, Zhao W, Guan H. Next-Generation Sequencing of Cerebrospinal Fluid for the Diagnosis of Neurocysticercosis. Front Neurol 2018; 9:471. [PMID: 29971042 PMCID: PMC6018529 DOI: 10.3389/fneur.2018.00471] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/31/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system (CNS). The diagnosis of NCC is sometimes challenging due to its heterogenous clinical manifestations and the variable sensitivity and specificity of neuroimaging and serological tests. Methods: Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) was used to detect pathogens in patients with clinically suspected CNS infections. A series of patients diagnosed with NCC is reviewed here. Results: Using NGS of CSF, four patients were diagnosed with NCC. The reads corresponding to Taenia solium ranged from 478 to 117,362, with genomic coverage of 0.0564-11.15%. Reads corresponding to T. solium were not found in non-template controls and far exceeded those of the background microorganisms in patients with NCC, facilitating the interpretation of the NGS results. Conclusions: This case series demonstrates that NGS of CSF is promising in the diagnosis of NCC in difficult to diagnose cases. Larger studies are needed in the future.
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Affiliation(s)
- Siyuan Fan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Qiao
- Department of Neurology, Affiliated Hospital of Chifeng University, Chifeng, China
| | - Lei Liu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Honglong Wu
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Jiali Zhou
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Ruixue Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Qing Chen
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Yan Huang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chenhui Mao
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Lu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Ge
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongjun Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Haitao Ren
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weili Zhao
- Department of Neurology, Affiliated Hospital of Chifeng University, Chifeng, China
| | - Hongzhi Guan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Carpio A, Campoverde A, Romo ML, García L, Piedra LM, Pacurucu M, López N, Aguilar J, López S, Vintimilla LC, Toral AM, Peña-Tapia P. Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017; 4:e324. [PMID: 28105460 PMCID: PMC5241005 DOI: 10.1212/nxi.0000000000000324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/07/2016] [Indexed: 12/01/2022]
Abstract
Objective: To prospectively evaluate the validity of a PCR assay in CSF for the diagnosis of neurocysticercosis (NC). Methods: We conducted a multicenter, prospective case-control study, recruiting participants from 5 hospitals in Cuenca, Ecuador, from January 2015 to February 2016. Cases fulfilled validated diagnostic criteria for NC. For each case, a neurosurgical patient who did not fulfill the diagnostic criteria for NC was selected as a control. CT and MRI, as well as a CSF sample, were collected from both cases and controls. The diagnostic criteria to identify cases were used as a reference standard. Results: Overall, 36 case and 36 control participants were enrolled. PCR had a sensitivity of 72.2% (95% confidence interval [CI] 54.8%–85.8%) and a specificity of 100.0% (95% CI 90.3%–100.0%). For parenchymal NC, PCR had a sensitivity of 42.9% (95% CI 17.7%–71.1%), and for extraparenchymal NC, PCR had a sensitivity of 90.9% (95% CI 70.8%–98.9%). Conclusions: This study demonstrated the usefulness of this PCR assay in CSF for the diagnosis of NC. PCR may be particularly helpful for diagnosing extraparenchymal NC when neuroimaging techniques have failed. Classification of evidence: This study provides Class III evidence that CSF PCR can accurately identify patients with extraparenchymal NC.
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Affiliation(s)
- Arturo Carpio
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Alfredo Campoverde
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Matthew L Romo
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Lorena García
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Luis M Piedra
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Mónica Pacurucu
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Nelson López
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Jenner Aguilar
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Sebastian López
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Luis C Vintimilla
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Ana M Toral
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Pablo Peña-Tapia
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
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Fabiani S, Bruschi F. Neurocysticercosis in Europe: Still a public health concern not only for imported cases. Acta Trop 2013; 128:18-26. [PMID: 23871891 DOI: 10.1016/j.actatropica.2013.06.020] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/22/2013] [Accepted: 06/30/2013] [Indexed: 10/26/2022]
Abstract
Neurocysticercosis (NCC), a parasitic disease caused by the larvae of the cestode Taenia solium, is the most frequent parasitic disease of the central nervous system (CNS) in the world and the leading cause of secondary epilepsy in Central and South America, East and South Asia, and sub-Saharan Africa. It is endemic in many low- and middle-income countries of the world. Due to increased travels and immigration, NCC may be diagnosed also in non-endemic areas. In fact, tapeworm carriers from endemic zones can transmit infection to other citizens or arrive already suffering NCC. This phenomenon, occurred first in USA during the last 30 years, has been also observed in Europe, as well as in Australia, Canada, Israel, Japan and Muslim countries of the Arab World. Actually, concerning Europe, although, in some areas only few cases have been described, nevertheless the prevalence of NCC may be considered increasing, especially in Spain and Portugal. We reviewed the literature on the burden of NCC in Europe, by a search of PubMed regarding papers from 1970 to present. We only considered on PubMed published and available papers in English, French, Italian, and Spanish, the languages understood by the authors. One hundred seventy six cases of NCC have been reported in seventeen European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Netherlands, Sweden, United Kingdom, and Croatia, Norway, Switzerland). A particular epidemic situation is present in Spain and Portugal. In fact, we collected data that show, in Spain, an increasing incidence both in immigrated patients and in those which were born in certain Spanish geographical areas and, in Portugal, prevalence similar to that observed in endemic areas. Globally, it is clear that as a result of increased migrations and travels from endemic regions, NCC is becoming an emerging public health problem in high-income countries, particularly affecting communities where hygiene conditions are poor and sub-sequentially the parasite can spread from human to human through eggs even in absence of a travel to the tropics. NCC is a preventable disease, it derives that it's important to acquire a great consciousness of the epidemiology and to implement accurate surveillance systems.
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Zammarchi L, Strohmeyer M, Bartalesi F, Bruno E, Muñoz J, Buonfrate D, Nicoletti A, García HH, Pozio E, Bartoloni A. Epidemiology and management of cysticercosis and Taenia solium taeniasis in Europe, systematic review 1990-2011. PLoS One 2013; 8:e69537. [PMID: 23922733 PMCID: PMC3726635 DOI: 10.1371/journal.pone.0069537] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cysticercosis is caused by the invasion of human or pig tissues by the metacestode larval stage of Taenia solium. In Europe, the disease was endemic in the past but the autochthonous natural life cycle of the parasite is currently completed very rarely. Recently, imported cases have increased in parallel to the increased number of migrations and international travels. The lack of specific surveillance systems for cysticercosis leads to underestimation of the epidemiological and clinical impacts. OBJECTIVES To review the available data on epidemiology and management of cysticercosis in Europe. METHODS A review of literature on human cysticercosis and T. solium taeniasis in Europe published between 1990-2011 was conducted. RESULTS Out of 846 cysticercosis cases described in the literature, 522 cases were autochthonous and 324 cases were imported. The majority (70.1%) of the autochthonous cases were diagnosed in Portugal from 1983 and 1994. Imported cases of which 242 (74.7%) diagnosed in migrants and 57 (17.6%) in European travellers, showed an increasing trend. Most of imported cases were acquired in Latin America (69.8% of migrants and 44.0% of travellers). The majority of imported cases were diagnosed in Spain (47.5%), France (16.7%) and Italy (8.3%). One third of neurosurgical procedures were performed because the suspected diagnosis was cerebral neoplasm. Sixty eight autochthonous and 5 imported T. solium taeniasis cases were reported. CONCLUSIONS Cysticercosis remains a challenge for European care providers, since they are often poorly aware of this infection and have little familiarity in managing this disease. Cysticercosis should be included among mandatory reportable diseases, in order to improve the accuracy of epidemiological information. European health care providers might benefit from a transfer of knowledge from colleagues working in endemic areas and the development of shared diagnostic and therapeutic processes would have impact on the quality of the European health systems.
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Affiliation(s)
- Lorenzo Zammarchi
- Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Florence, Italy
| | - Marianne Strohmeyer
- Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Florence, Italy
| | - Filippo Bartalesi
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Elisa Bruno
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - José Muñoz
- Servicio de Medicina Tropical y Salud Internacional, Centre de Recerca en Salut Internacional de Barcelona, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Dora Buonfrate
- Centre for Tropical Diseases, Sacro Cuore Hospital, Via Don Sempreboni, Negrar (Verona), Italy
| | - Alessandra Nicoletti
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Héctor Hugo García
- Cysticercosis Unit, Instituto de Ciencias Neurologicas, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edoardo Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Bartoloni
- Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence School of Medicine, Florence, Italy
- SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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