Other cestodes: sparganosis, coenurosis and Taenia crassiceps cysticercosis

Abstract

Many cestodes are capable of invading the central nervous system (CNS), and several are highly prevalent in the developing world. Neurocysticercosis due to Taenia solium and echinococcosis due to Echinoccocus granulosus are two of the most common parasitic infections affecting humans, but other less well-known parasites can also infect the nervous system. Coenurosis, caused by Taenia spp. such as T. multiceps, T. serialis, or T. brauni; sparganosis, caused by Spirometra spp., and neurocysticercosis caused by T. crassiceps are three less frequent zoonotic conditions that should be considered in the differential diagnosis of patients presenting with CNS infection - especially if they have lived in or traveled through areas where these infections are endemic. Diagnosis of these infections is typically made through a combination of serological testing, histopathology, and neuroimaging.

Keywords: Central nervous system; Spirometra spp.; Taenia crassiceps; Taenia multiceps; cestodiasis; coenurosis; cysticercosis; parasites; sparganosis; zoonoses.

Fig. 27.1

Sparganosis transmission cycle. From Centers for Disease Control and Prevention (CDC), 2011 (http://www.dpd.cdc.gov/DPDx/HTML/Sparganosis.htm). Use approved by CDC DPDx.

Fig. 27.2

Live Spirometra mansoni worm found during parietal craniotomy. (From Nobayashi et al., 2006, with permission.)

Fig. 27.3

Migrating Spirometra erinaceieuropaei larva in the brain and tunnel sign on magnetic resonance imaging after application of contrast. Original legend as published: “MRIs demonstrate the migration of the lesion from the cerebellar hemisphere to the vermis over a period of 7 weeks. (A) Initial image, (B) 4 weeks later, and (C) 7 weeks later. The tunnel sign appearing as a hollow tube (arrow) represents the moving track of a migrating worm. Giemsa-stained CSF (D) shows a high number of eosinophils.” (From Shirakawa et al., 2010; use approved by corresponding author.)

Fig. 27.4

Life cycle of coenurosis-causing taeniid species. From Centers for Disease Control and Prevention (CDC) 2011 (http://www.dpd.cdc.gov/dpdx/html/Coenurosis.htm). Use approved by CDC DPDx.

Fig. 27.5

Coenurus larvae excised from the brain of a sheep in Huancayo, Peru, showing multiple scolices on its wall. (Courtesy of Dr. Saul Santivañez.)

Fig. 27.6

Computed tomography and magnetic resonance imaging (upper panel) and coenurus cysts excised from a 4-year-old girl in Israel. The outer and inner cysts are 13 and 6 cm in diameter, respectively. (Reprinted with kind permission from Veterinaria Italiana, 44(4), 621–31, 2008, El-On et al.)

Fig. 27.7

Domestic cat brain with approximately 20 – 25 intraventricular T. crassiceps cysticerci. (From Wunschmann et al., 2003, with permission from Journal of Veterinary Diagnostic Investigation.)

Fig. 27.8

Subcutaneous T. crassiceps infection in the hand presenting with characteristic proliferation. (From Heldwein et al., 2006, with permission from the American Journal of Tropical Medicine & Hygiene.)