Friday, March 15, 2024

Neurocysticercosis

A man suffering from severe migraines, obesity and complicated type-2 diabetes was found to have parasitic tapeworm larvae in his brain, which was the result of eating partially cooked bacon, according to a report published by the American Journal of Case Reports last week.

The 52-year-old man had a medical history of chronic migraines, type-2 diabetes mellitus which was complicated by peripheral neuropathy, hyperlipidemia and obesity.

The study noted that the man told doctors his migraines occurred almost weekly and were not responsive to medication. He also said he did not travel to high-risk areas, lived at home with his wife and cat, and preferred lightly cooked, non-crispy bacon, which he admitted having eaten most of his life.

The man underwent numerous tests, including a CT scan, which uncovered multiple cysts in his brain. But there was no evidence of hydrocephalus, or buildup of fluid.

Doctors also conducted an MRI which demonstrated the same findings as the CT, but also noted there was concern about neurocysticercosis.

"Cysticercosis is a condition caused by infection with the larval form of Taenia Solium, a pork tapeworm that uses pigs as an intermediate host," the study read. "Humans become infected when they ingest water or food contaminated with tapeworm cysts."

The man underwent more tests to find out more on a correlation between the migraines and Cysticercosis, involving blood and urine cultures and HIV antibodies, though all came back nonreactive.

But when the Cysticercosis lgG Cysts antibody came back with a positive result, doctors were able to confirm the suspicion of neurocysticercosis.

Researchers said the man’s "preference for soft bacon" could have led to him developing an intestinal tapeworm.

They then put him under a regime of medications, and after 14 days, he was determined to be successfully treated.

Researchers said the man’s "lifelong preference for soft bacon" could have led to him developing an intestinal tapeworm and not cysticercosis.

"Taeniasis occurs when consuming undercooked pork and the larval cysts embedded within, while cysticercosis is contracted when humans ingest eggs found in the feces of other humans with taeniasis," researchers wrote.

"It can only be speculated, but given our patient’s predilection for undercooked pork and benign exposure history, we favor that his cysticercosis was transmitted via autoinfection after improper handwashing after he had contracted taeniasis himself from his eating habits."

The Centers for Disease Control and Prevention warns that if a person consumes undercooked and infected pork, then gets tapeworm infection in the intestines, that person will pass the eggs in their feces.

Cysticercosis typically occurs in low-income countries, the CDC noted, though people who have never traveled outside the U.S. could still contract it.

"A person infected with a tapeworm who does not wash his or her hands might accidentally contaminate food with tapeworm eggs while preparing it for others," the CDC said.

After entering the body, the eggs hatch and the larvae sometimes attach to the brain.

Symptoms of cysticercosis include headache, epilepsy, dizziness and stroke.

https://www.foxnews.com/health/man-suffering-migraines-found-tapeworms-brain-consuming-partially-cooked-bacon-study?dicbo=v2-x4wTNpr
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Byrnes E, Shaw B, Shaw R, Madruga M, Carlan SJ. Neurocysticercosis Presenting as Migraine in the United States. Am J Case Rep. 2024 Mar 7;25:e943133. doi: 10.12659/AJCR.943133. PMID: 38449298; PMCID: PMC10932825.

Abstract

BACKGROUND Cysticercosis is a condition caused by infection with the larval form of Taenia solium, a pork tapeworm that uses pigs as an intermediate host. Humans become infected when they ingest water or food contaminated with tapeworm cysts. Cysticercosis is increasing in frequency in developed countries due to increased access to travel. Neurocysticercosis occurs when Taenia solium cysts embed within the nervous system. The clinical presentation of neurocysticercosis ranges from asymptomatic to life-threatening, largely depending on the brain parenchymal involvement. The diagnosis is typically made with a combination of clinical evaluation, serology, and neuroimaging. Treatment for parenchymal neurocysticercosis may involve anthelmintic agents, symptomatic agents, surgery, or a combination of methods. CASE REPORT A 52-year-old man with a medical history of migraine headaches, complicated type 2 diabetes mellitus, and obesity presented with a 4-month change in his migraines becoming severe, worse over his occiput bilaterally, and unresponsive to abortive therapy. His exposure history was unremarkable except for a habit of eating undercooked bacon, by which he would have developed neurocysticercosis via autoinfection. Neuroimaging and serology confirmed a diagnosis of neurocysticercosis and he was treated accordingly with antiparasitic and anti-inflammatory medications. CONCLUSIONS This presentation is nonspecific and can easily be overlooked, especially if there is an underlying known neurological condition such as migraine. This case illustrates that neurocysticercosis should be considered when an existing neuropathological condition displays a change in presentation or requires a change in therapeutic management, even without obvious risk factors.

See: https://childnervoussystem.blogspot.com/2018/07/cerebral-cysticercosis.html

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