Multiple cysticercus nodules in skin and brain in a Balinese woman: A case report

Abstract

Dilaporkan kasus seorang perempuan Bali, berumur 33 tahun, agama Hindu dengan nodul multipel sistiserkosis di bawah kulit dan otak. Ditemukan gejala kejang sejak remaja yang kemudian tidak diobati. Sejak tiga tahun sebelum dirawat di rumah sakit, penderita menemukan nodul multipel di dalam kulit, mulai pada dahi dan sejak setahun yang lalu juga di bagian lain dari kepala dan tubuh, seperti pada bahu, dada dan punggung. Ternyata sampel serum yang diperiksa dengan cara immunoblot positif terhadap antigen Taenia solium. Hasil tes kopro-antigen yang juga positif memberi petunjuk adanya cacing dewasa T. solium di usus. Penderita diterapi dengan prazikuantel terhadap infeksi dengan cacing dewasa dan kemudian dengan albendazol terhadap stadium larva, yang berupa kista. Tidak berhasil ditemukan cacing dewasa di dalam tinja 24 jam. Setelah tiga minggu jumlah kista yang teraba di dalam kulit sangat berkurang, demikian juga di dalam otak. Setelah setahun tes imunoblot masih positif.

Recent advances and perspectives in molecular epidemiology of Taenia solium cysticercosis

“…saginata is well known to be common in local people in Bali, Indonesia (Suweta, 1991;Depary and Kosman, 1991;Theis et al, 1994;Simanjuntak et al, 1997;Margono et al, 2002Margono et al, , 2005Wandra et al, 2006Wandra et al, , 2015. Throughout our field work in Bali from 2002 until 2010, all tapeworms discharged from more than 100 tapeworm carriers were definitively identified as T. saginata (Wandra et al, 2015).…”

“…1 and 2). Disseminated cysticercosis cases are caused mainly in tapeworm carriers themselves by autoinfection even if detection of tapeworm(s) is not always easy (Schantz et al, 1983Margono et al, 2002;Kobayashi et al, 2013;. The only definitive host of T. solium is human, Homo sapiens (de Queiroz and Alkire, 1998;Hoberg et al, 1999Hoberg et al, , 2001Hoberg, 2002Hoberg, , 2006Michelet and Dauga, 2012;Zarlenga et al, 2014a,b).…”

“…One is taeniasis after eating contaminated pork. This group is at high risk of disseminated cysticercosis due to autoinfection (Margono et al, 2002;Kobayashi et al, 2013). The other is cysticercosis accidentally caused by contamination with eggs released from tapeworm carriers everywhere either pork is eaten or not (Schantz et al, 1992;Ikejima et al, 2005).…”

“…In rural areas on Bali where access to the capital city is not difficult through semi-urbanization other than the endemic rural areas, high dose of PZQ may be recommended, because the on time treatment of seizure attacked patients is possible. Or alternatively, we recommend introduction of serology for cysticercosis in screening of taeniasis carriers and STHs in order to detect asymptomatic NCC based on the recognition that cryptic infections are endemic and potentially most lethal parasitic disease on Bali (Margono et al, 2002;Sudewi et al, 2008;Wandra et al, 2015). When some people are confirmed antibody positive to diagnostic antigens for cysticercosis (Ito et al, 1998Sako et al, 2013;, they are recommended to admit big city hospital(s) for further treatment.…”

Neurocysticercosis Diagnosed in a Patient with Taenia saginata Taeniasis after Administration of Praziquantel: A Case Study and Review of the Literature

“…However, education programs aimed at keeping pigs indoors to prevent access to human faeces and the introduction of improved sanitation systems and practices have substantially reduced the prevalence of NCC during the past 2 decades [35,37,43]. Nevertheless, there are still sporadic NCC cases identified on Bali [40,[42][43][44][45]. …”