Signs, symptoms and treatment of taeniasis/cysticercosis

Taeniasis due to T. solium is usually characterized by mild and non-specific signs and symptoms; 6-8 weeks after ingestion of the cysticerci, abdominal pain, nausea, diarrhoea or constipation might arise and last until the tapeworm dies following treatment (otherwise it may live many years).

The incubation period for cysticercosis due to T. solium is variable, and infected people may remain asymptomatic for years. The location of infection that most often prompts a medical consultation is the brain, followed by the eye and its surrounding tissues. When cysts are recognized by the host following spontaneous degeneration or after treatment, an inflammatory reaction may occur; this usually results in clinical signs and symptoms, including chronic headaches, blindness, seizures (epilepsy if they are recurrent), hydrocephalus, meningitis, symptoms caused by lesions occupying spaces of the central nervous system, and dementia. The duration of signs and symptoms associated with cysticercosis, and the proportion of patients who will fully recover with or without treatment, are ill-defined.

In severe cases, neurocysticercosis may be fatal and it has been noted as a cause of death in Brazil and the United States. Oedema around calcified cysticercal granulomas also has been found to cause symptoms.

Treatment of taeniasis may include administration of praziquantel (5-10 mg/kg, single-administration) or niclosamide (adult and children over 6 years: 2 g, single-administration after a light breakfast, followed after 2 hours by a laxative; children aged 2-6 years: 1 g; children under 2 years: 500 mg). The treatment of human cysticercosis is more challenging and may include long courses with praziquantel and/or albendazole, as well as supporting therapy with corticosteroids and/or anti-epileptic drugs.

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