This 29-year-old woman was admitted to the hospital because of repeated tonic-clonic seizures. The patient was a tour guide leading groups of tourist to Tibet for two-month walking/camping tours in the Himalayas. Her seizures were easily controlled by intravenous administration of phenytoin. The WBC count was 13,000, with 5% eosinophils and the erythrocyte sedimentation rate was slightly elevated. A cranial CT performed with and without contrast revealed two ring-enhancing lesions. The patient underwent a craniotomy and excisional biopsy.
Histopathologic exam revealed a capsule of dense connective tissue surrounding a cavity that contained a partially degenerated scolex of Taenia solium.
Cysticercosis is caused by the cestode parasite, Taenia solium (pig tapeworm). Cysticercosis is contracted by ingesting eggs from the feces of a person infected with an adult Taenia solium. The eggs can survive for several weeks in soil but are also infectious as soon as passed. The larvae migrate through the intestinal wall and are disseminated via the blood stream and can encyst in the brain, heart, skeletal muscle, or skin.
- eMedicine Medical Library: Cysticercosis
- eMedicine Medical Library: Cysticercosis in Emergency Medicine
- Merck Manual: Taeniasis Solium and Cysticercosis
- Garcia HH, Del Brutto OH. Taenia solium cysticercosis. Infect Dis Clin North Am 2000 Mar;14(1):97-119, ix.
A tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions.
A normal white blood cell count is 4000-11,000 cells/mm³.
An elevated erythrocyte sedimentation rate is a non-specific indicator of inflammation.