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| cysticercosis [2026/05/26 18:23] – Scott Larson | cysticercosis [2026/05/26 18:35] (current) – Scott Larson | ||
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| * The larvae spread hematologically and settle in tissues, especially the CNS and eye. | * The larvae spread hematologically and settle in tissues, especially the CNS and eye. | ||
| * Neurocysticercosis is the leading cause of epilepsy in endemic areas | * Neurocysticercosis is the leading cause of epilepsy in endemic areas | ||
| + | * Endemic areas | ||
| + | * Latin America, sub-Saharan Africa, Indian Subcontinent, | ||
| + | * In the USA (not endemic) cases are more often seen among immigrant populations | ||
| =====Diagnosis==== | =====Diagnosis==== | ||
| * Neuroimaging | * Neuroimaging | ||
| Line 15: | Line 18: | ||
| * Well defined cystic lesion with eccentric intracystic echogenic focus (nidus) representing the scolex, thick cyst wall, surrounding inflammation and retinal detachment | * Well defined cystic lesion with eccentric intracystic echogenic focus (nidus) representing the scolex, thick cyst wall, surrounding inflammation and retinal detachment | ||
| * Serologic testing- enzyme linked immunoelectrotransfer blot assay (EITB) | * Serologic testing- enzyme linked immunoelectrotransfer blot assay (EITB) | ||
| - | * Endemic areas | ||
| - | * Latin America, sub-Saharan Africa, Indian Subcontinent, | ||
| - | * In the USA (not endemic) cases are more often seen among immigrant populations | ||
| ====Ocular manifestations==== | ====Ocular manifestations==== | ||
| Line 36: | Line 36: | ||
| * Intraocular cysts require surgical removal | * Intraocular cysts require surgical removal | ||
| * Vitrectomy and cyst removal and repair of retinal detachment | * Vitrectomy and cyst removal and repair of retinal detachment | ||
| + | * Subconjunctival cysts are usually removed as well. | ||
| * Cysticidal therapy can cause severe ocular inflammation | * Cysticidal therapy can cause severe ocular inflammation | ||
| - | | + | |
| - | * Albendazole | + | * Albendazole |
| - | * possible persistent motility restriction, | + | * Standard regimen: |
| + | * albendazole PO (15mg/ | ||
| + | * prednisone PO (1mg/ | ||
| + | | ||
| + | * Treatment response monitored by vision exam, and repeat imaging. | ||
| + | * If cystic lesions persist beyond 6-12 months, retreatment is recommended. | ||
| + | * albendazole can be repeated, praziquantel can be added or switched to. | ||
| + | * a combination may be superior if ≥ 3 cysts | ||
| + | * Monitor: liver enzymes, CBC | ||
| + | * Hepatotoxicity occurs in 16% | ||
| + | * Leukopenia in 10% | ||
| + | * Reversable alopecia may occur | ||
| + | * More common to have above with more prolonged treatment | ||
| ====References==== | ====References==== | ||
| - [[https:// | - [[https:// | ||
| + | - [[https:// | ||