A patient with a known tapeworm (Taenia solium) infection is now found to have multiple ring-enhancing lesions on brain MRI. CSF shows eosinophilia. Serology is positive for Taenia solium antibodies by ELISA. What is the most specific confirmatory test for neurocysticercosis?

• A Indirect hemagglutination assay (IHA)
• B ELISA for T. solium cysticercus antibodies in serum
• C Latex agglutination test
• D Enzyme-linked immunoelectrotransfer blot (EITB) assay using glycoprotein antigens ✓

Explanation

The EITB (Western blot) assay using lentil lectin-purified glycoprotein antigens from T. solium cysticerci has sensitivity of ~98% and specificity approaching 100% in patients with multiple lesions and is the CDC-recommended confirmatory serological test for neurocysticercosis. Standard ELISA has cross-reactivity with Echinococcus and other cestodes, reducing specificity. IHA and latex agglutination are less specific. CSF EITB may yield false negatives in single-cyst disease, but serum EITB remains the reference.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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