Taenia solium infection (Taeniasis) is an intestinal infection with adult tapeworms due to ingestion of contaminated pork. Cysticercosis is an infection with larvae of T. solium, which after ingestion of eggs, which are excreted in human stool, develop. Adult worms can cause mild gastrointestinal symptoms and lead to the elimination of moving segments in the stool. Cysticercosis is asymptomatic until the larvae affect the brain in general and cause a neurocysticercosis, which can lead to seizures and various other neurological disorders. A neurocysticercosis can be detected by imaging techniques of the brain. Less than half of all patients with neurocysticercosis has an infection of the intestine with adult T. solium and can therefore be withdrawn in the stool eggs or proglottids. Adult worms can be eradicated with praziquantel. The treatment of symptomatic neurocysticercosis with corticosteroids, anticonvulsants and in some cases, albendazole or praziquantel. Surgery may be required.

(See also Overview of tapeworm infections.)

Taenia solium infection (Taeniasis) is an intestinal infection with adult tapeworms due to ingestion of contaminated pork. Cysticercosis is an infection with larvae of T. solium, which after ingestion of eggs, which are excreted in human stool, develop. Adult worms can cause mild gastrointestinal symptoms and lead to the elimination of moving segments in the stool. Cysticercosis is asymptomatic until the larvae affect the brain in general and cause a neurocysticercosis, which can lead to seizures and various other neurological disorders. A neurocysticercosis can be detected by imaging techniques of the brain. Less than half of all patients with neurocysticercosis has an infection of the intestine with adult T. solium and can therefore be withdrawn in the stool eggs or proglottids. Adult worms can be eradicated with praziquantel. The treatment of symptomatic neurocysticercosis with corticosteroids, anticonvulsants and in some cases, albendazole or praziquantel. Surgery may be required. (See also Overview of tapeworm infections.) Manifestation, diagnosis and treatment of intestinal infection with the adult T. solium tapeworm are similar to those of T. Saginata- (beef tapeworm) infection. However, people can also act as intermediate hosts for the larvae of T. solium when they ingest eggs of T. solium derived from human stools (lifecycle vonTaenia solium.). Some experts postulate that in the presence of an adult tapeworm in the intestine gravid proglottids (tapeworms segments) retrogradely from the intestines to the stomach can pass, where oncospheres (immature parasitic forms, which are included in an embryonic shell) slip and into subcutaneous tissue, muscle, intestines and can hike CNS. Adult tapeworms can be located for years in the small intestine. They can be 2-7 meters long and can produce up to 1,000 proglottids, each of which contains about 50,000 eggs. Lifecycle vonTaenia solium. People develop intestinal infections with adult worms after taking contaminated pork or cysticercosis after taking eggs of T. solium (what people make intermediate hosts). 1. People take raw or undercooked pork containing cysticerci (larvae). 2. After recording cysts are formed, dedicated to the scolex (head) attach to the small intestine and mature in about two months into adult worms. 3. Adult tapeworms produce proglottids that are pregnant. They dissolve from the tapeworm and migrate to the anus. 4. Phased proglottids, eggs or both of the final host (humans) are excreted in the feces. 5. pigs or humans by ingestion of embryonated eggs or pregnant proglottids (z. B. in fecal contaminated food) infected. A car infection can occur in humans when Proglottiden from the intestine through the reverse peristalsis reach the stomach. 6. Once the eggs have been added, they hatch in the intestine and release oncospheres that penetrate the intestinal wall. 7. oncospheres travel through the bloodstream to the striated muscles and the brain, the liver and other organs where they develop into cysticerci. It can lead to cysticercosis. Taeniasis and cysticercosis occur worldwide. The cysticercosis is predominant and neurocysticercosis is a major cause of seizure disorders in Latin America. Cysticercosis is rare in Muslim countries. An infection occurs in the United States most frequently among immigrants before, but North Americans who were not abroad, are solium by the ingestion of eggs of immigrants, the adult T.. harboring infected. In rare cases zoonosis caused Taenia spp other than T. solium neurocysticercosis. Symptoms and complaints intestinal infection with adult T. solium worms infected people are asymptomatic or have only mild gastrointestinal discomfort. Proglottiden can be seen in her chair sein.Zystizerkose Living cysticerci (larva) lead in most organs only minimal or no tissue reaction, but the death of the cysts in the brain can lead to intense tissue reactions. Consequently, complaints can often missing for years after infection. An infection of the brain (cerebral cysticercosis) due to the displacement effect and the inflammatory response to the degeneration of the cysticercus cause serious symptoms and release antigens. Depending on the location and number of cysticerci patients can have with neurocysticercosis seizures, signs of increased intracranial pressure hydrocephalus, focal neurological complaints, changes in mental status or an aseptic meningitis. can cysticerci the spinal cord, the muscles, the subcutaneous connective tissue and the eyes become infected. After an infection with larvae, a significant secondary immunity developed. Diagnosis Microscopic examination of the stool on eggs and proglottids CT and / or MRI and serologic tests for patients with nervous system symptoms Intestinal infection with adult T. solium worms can usually by microscopic examination of stool samples and the identification of eggs and / or Proglottiden be detected. However, the eggs of T. saginata not and T. asiatica are. T. solium eggs can be detected 50% of the stool samples of patients with cysticercosis only at ?. Cysticercosis is usually diagnosed when a CT or MRI is prepared to clarify neurological complaints. The sectional images can show fixed node, cysticerci, calcified cysts, ring enhanced lesions or hydrocephalus. The CDC ( “Centers for Disease Control and Prevention”) immunoblot assay (using a serum sample) is highly specific and sensitive than other enzyme immunoassays (especially if> 2 CNS lesions are present; the sensitivity is lower when only one cyst is present ). Tips and risks T. solium eggs can be detected 50% of the stool samples of patients with cysticercosis at ?. Therapy for intestinal infections: praziquantel or niclosamide (outside of the United States) In neurocysticercosis: corticosteroids, anticonvulsants and sometimes albendazole or praziquantel and / or surgical intervention treatment of intestinal infection Intestinal infection is treated with praziquantel 5-10 mg / kg as a single dose to adult worms to eradicate. Praziquantel should be used with caution in patients who also have a neurocysticercosis because praziquantel can trigger an inflammatory response by killing cysts associated with seizures or other symptoms. Alternatively, a single dose (2 g) niclosamide (not available in the US) are given in the form of 4 tablets of 500 mg, to be chewed together and swallowed with a small amount of water. For children, the dose is 50 mg / kg (maximum 2 g) einmalig.Behandlung of neurocysticercosis, the initial treatment goals for the symptomatic neurocysticercosis documented to reduce the inflammation associated with degenerate cysticerci by MRI To prevent seizures, if present, or if the risk is high to raised intracranial pressure, if available to reduce, corticosteroids (prednisone 60 mg po 1-times daily or dexamethasone 6 mg po 1 time daily) are used to reduce inflammation and increased intracranial pressure. Conventional anticonvulsants are prescribed with seizures patients. These drugs can be used prophylactically in patients at high risk of seizures, particularly those who have more degenerate lesions with concomitant inflammation. A neurosurgical purely attacked may be required for patients with increased intracranial pressure or intraventricular cysticerci. The anthelmintic treatment of neurocysticercosis is complicated and consultation with an expert is recommended. The treatment choice depends on the location, number and size of cysticerci, stage of disease and the clinical manifestations. Not all patients respond to therapy, and not all patients need to be treated (the cysts may already be dead and calcified, or the inflammatory response to treatment can be worse than the disease itself). When a nthelmintische treatment is used, albendazole seems to 7.5 mg / kg p. o. to be twice / day for 15 days effective than the alternative Praziquantel 16.6 mg / kg p. o. 2 times daily for 15 days, but some patients who have not responded to albendazole reacted to Praziquantel. given albendazole for ? 30 days was used to treat extensive disease and cysts in the subarachnoid space (racemose cysticercosis), are less responsive to anthelmintic drugs. Occasionally, albendazole and praziquantel also be used together. Either prednisone or dexamethasone is administered simultaneously with the anthelmintic, to reduce the inflammation that occurs in response to the dying cysts in the brain. Corticosteroids increase the GRP levels of the active metabolite of albendazole, but reduce the GRP levels of praziquantel. In patients with involvement of the eyes or cysticerci in the spinal cord either albendazole still praziquantel should be used. Intraventricular cysticerci are a relative contraindication for an anthelmintic, because the resulting inflammatory response, which is triggered by the dying cysts can lead to obstructive hydrocephalus. In obstructive hydrocephalus (due intraventricular cysticerci, including those in the fourth ventricle), infection of the IV. Ventricle or a spinal or ocular cysticercosis surgery may be required. intraventricular be cysticerci, if possible, removed endoscopically. Ventricular shunt may be required to reduce increased intracranial pressure. Prevention The identification and treatment of carriers of adult tapeworm is an important public health measure. In the US, transmission occurred from people who were infected in endemic areas and returned home sind.wurden A thorough hand washing is important, especially for people in the food industry. With travel to endemic areas with poor sanitary conditions should be taken to avoid foods that could be contaminated by human feces. Key points The ingestion of T. solium cysts can cause an intestinal infection; the ingestion of eggs can lead to tissue cysts (cysticercosis) lead, which are particularly problematic in the brain. Patients with neurocysticercosis may have seizures, signs of intracranial pressure, changes in mental status, focal neurologic symptoms or aseptic meningitis. The diagnosis of infection with adult worms carried out with a microscopic examination of the stool. The diagnosis of neurocysticercosis is done by by neuroimaging and serological tests. Praziquantel is administered for intestinal infection. For neurocysticercosis an expert is consulted; usually corticosteroids are given with anticonvulsants patients who have seizures associated or of which it is assumed that they have a high risk of seizures. Use of anthelmintics and / or surgery in Neurocysticercosis depends on the location, number and stage of cysticerci, disease stage and clinical manifestations from.

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