A patient with epilepsy of new onset has multiple ring-enhancing cystic lesions in the brain on MRI with a scolex visible in one lesion. He works on a pig farm and lives in a rural area with poor sanitation. The condition is:

• A Hydatid disease (Echinococcus granulosus)
• B Cerebral malaria
• C Neurocysticercosis (Taenia solium larva) ✓
• D Cerebral toxoplasmosis

Explanation

Neurocysticercosis, caused by the larval stage (cysticercus cellulosae) of Taenia solium, is the most common cause of acquired epilepsy in the developing world. Humans acquire cysticercosis by accidentally ingesting T. solium eggs (from feco-oral contamination or auto-infection), becoming accidental intermediate hosts. The scolex within the cyst is pathognomonic on MRI. The vesicular cyst eventually degenerates, causing inflammatory edema and seizures. Pigs are the natural intermediate hosts; humans are the definitive host for the adult tapeworm when they eat undercooked pork.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.