Fast Five Quiz: Are You Prepared to Confront Parasitic Infections?

Michael Stuart Bronze, MD


June 29, 2017

If neurocysticercosis develops after T solium infection, seizure is the most common form of presentation, occurring in up to 80% of patients with parenchymal brain cysts or calcifications.

Hymenolepis (intestinal tapeworm) typically produces asymptomatic infections; however, patients with a heavy burden of parasites may present with vague symptoms of anorexia, abdominal pain, and diarrhea (the developing cysticercoids destroy their housing villi; thus, with a number of parasites, significant enteritis may develop). Host nutrition and immunity regulates worm burden. Diphyllobothrium infestations may result in abdominal discomfort, diarrhea, vomiting, weakness, and weight loss.

In cystic echinococcosis, larvae distribute via the bloodstream and may result in the formation of large, slowly expanding fluid-filled cysts. The liver is the most common site, followed by the lungs (10%-30%), especially the right lobe (60%) and the lower lobes (60%); however, almost any tissue may be involved. In children, the lungs may be the most common site of cyst formation. As many as 40% of patients with lung cysts will have liver cysts as well.

Hepatic echinococcosis can cause epigastric pain and dyspepsia (≤ 35%) and can mimic cholelithiasis or jaundice (≤ 45%) from compression in the bile duct. In one third of the cases, the disease is found incidentally during the checkup for nonspecific symptoms (fatigue, weight loss, and hepatomegaly).

For more on tapeworm infestation, read here.


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