A Review of Cysticercosis; Dr. Katanga Kabulo from DRC in Africa

SUMMARY: Dr. Katanga Kabulo from the Democratic Republic of the Congo, states that Cysticercosis is common in Low Income Countries particularly in South America and Mexico, many countries in Africa, India, China and other SE Asian countries. These countries have 5 billion inhabitants. The disease has been known for more than 2000 years and in 1885 was connected to the tape worm found in the intestines. Humans are infected by ingesting the cyst infected uncooked pork of pigs  or unwashed food which the eggs grow in the intestines and form oncospheres which enter the blood stream to go the CNS, muscles, or other organs. Or the cysts release the scolex  which sticks to the intestine and grows to 8 meters and releases eggs which then transform to oncospheres and enter the blood stream  or are discharged in the feces and can infect the host or other people. The CNS is the preferential target organ of this Taenia Solum worm infection. The brain is involved in 60-90% of the infections. He shows the different stages and imaging appearance of the brain disease. The cysts are found mostly in the parenchyma of the brain but can be in the meninges in the pathology he shows. They can also be found in the CSF and ventricles all of which can lead to brain disease, seizures, ICP, mass effect, CSF blockage in the ventricles and meningitis or spinal involvement. CSF shows monocytosis and high protein ( leading to shunt failure). Testing of CSF against glycoprotein antigens with the EITB is the best test. He discusses the imaging characteristics. Treatment is with anti parasitic drugs, anti epileptics, steroids for edema, or surgery (cyst removal or shunting). He discusses the hygienic measures which have led to a decrease in the disease in Mexico, for example.  A number of case examples are presented. There was a discussion with neurosurgeons from Central, South America, Mexico, USA, various countries in Sub Saharan Africa and in Cuba and Iran. Excellent presentation by Dr. Kabulo, outstanding  anywhere in the world. Lecture and Discussion  50 minutes.  (JIA)

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