Pediatric Cysticercosis Follow-up

Updated: Oct 17, 2016
  • Author: Delaram Ghadishah, MD; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

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  • Treat seizures with anticonvulsant medications.

  • Follow-up with a neurologist is recommended for patients with numerous lesions or seizures.

  • Follow-up with an ophthalmologist is recommended for patients with visual lesions or complications.

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Further Inpatient Care

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  • Monitor patients with cysticercosis for anticonvulsant levels or signs of toxicity.

  • Monitor with serial neurologic examinations and initiate corticosteroid therapy if cerebral edema is present.

  • Place a ventriculoperitoneal shunt if acute hydrocephalus develops.

  • Brain surgery may be recommended for a mass effect, and ocular surgery may be recommended for the removal of cysts.

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Inpatient & Outpatient Medications

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  • Anticonvulsant medications as indicated

  • Corticosteroids for cerebral edema due to inflammation

  • Antihelminthic medications if indicated

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Transfer

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  • Transfer patients if specialized care, such as that provided by a neurosurgeon or ophthalmologist, is needed.

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Deterrence/Prevention

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  • Avoid areas and countries with poor hygiene.

  • Persons traveling to developing countries with high rates of endemic cysticercosis should avoid ingestion of unboiled or nonpurified water or ice cubes and should also avoid eating uncooked pork or vegetables and fruits that cannot be peeled.

  • All family members of an index patient with cysticercosis, as well as persons handling their food, should be examined for signs of disease or evidence of adult worm infection.

  • Persons known to have the adult T solium tapeworm should be immediately treated and should exercise care in handwashing to prevent contamination with feces.

  • Examine the stool of food handlers who have recently emigrated from countries with endemic disease for T solium eggs and proglottids.

  • Raw or undercooked pork should not be eaten, as this may result in infection with the adult tapeworm.

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Complications

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  • Complications of cysticercosis are numerous. They are most severe when they involve the CNS, visual, or cardiac system.

    • Permanent brain damage, seizures, strokes, hydrocephalus, and vague neurologic symptoms may result.

    • Blindness often results from ocular cysticercosis, despite antiparasitic and surgical treatment.

  • Muscle involvement may result in myositis and myocarditis.

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Prognosis

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  • The prognosis depends on the number and location of lesions, as well as the host response.

  • Treatment with antihelminthics may result in radiologic improvement of CNS lesions, but this may or may not result in clinical improvement.

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Patient Education

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  • Improved sanitation and hygiene are essential to the prevention of cysticercosis.

  • Use of toilets and proper disposal of human feces that may contain tapeworm eggs may eliminate transmission of infection. Avoid ingestion of unclean water. Proper cooking of pork may result in fewer T solium infections.

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