Undercooked Pork Led to Grandma's Seizure & Broken Hip

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#doctor #pork #neuroscience

🩺🪧Diagnosis:
L. hip fracture from a fall caused by a neurocystercosis induced seizure c/b disseminated cysticercosis acquired from pork tape-worm taenia solium

🪱 Life cycle of pork tape worm (Taenia solium):
- Patient has 2 separate infections caused by the same tape worm (tinea solium) leading to:
- 🍖🪱 Cysticercosis: ingestion of undercooked/raw infected pork➡️Tape worm embryos invade the bowel wall using their spikes (scolex) ➡️grow larger by feeding off host diet➡️ disseminate through blood into striated muscles, liver, &/or other tissues➡️in 3-8 weeks the tissue cysticerci develop (seen on imaging)
- 🧠🪱Neurocystercosis: consumption of parasite eggs from pork that was contaminated with feces of a person who is a tapeworm carrier (fecal-oral)➡️ingestion of eggs that cross the GI tract➡️migrating to the brain & crossing blood brain barrier➡️larval cysts (cysticerci) develop in the brain➡️seizures

🧪 Diagnostics:
- Stool test for ova & parasites
- Serologic testing (PCR, antigen or antibody detection for taenia solium)
- CSF fluid analysis (contraindicated in the setting of increased intracranial pressure)
- CT (identifying calcifications + parenchymal cysticerc)
- MRI (detecting small lesions, evaluating degenerative changes, detecting edema around calcified lesions, & visualizing scolices within calcified lesions)

💊 Treatment:
- Eye exam (exclude ocular cysticercosis which can threaten vision)
- Screening for latent tuberculosis infection as well as screening or empiric therapy for strongyloidiasis if they require Corticosteroids
- Corticosteroids if indicated
- Anti-seizure medications if indicated
- Antiparasitic therapy if indicated — 7 to 14 days in most cases (commonly albendazole or praziquantel)
- Follow-up imaging ~every 6 months following completion of initial antiparasitic therapy, until there is resolution of the cystic lesion