A patient with epilepsy and ring-enhancing lesions on MRI brain has serum ELISA positive for Taenia solium antibodies. Stool examination shows no Taenia ova. CSF is normal. What is the clinical diagnosis and preferred treatment?
- A Taeniasis intestinal (adult tapeworm) — treat with praziquantel 10 mg/kg single dose
- B Cerebral hydatid disease (Echinococcus granulosus) — treat with albendazole only, surgery contraindicated
- C Neurocysticercosis (NCC) — treatment with albendazole 15 mg/kg/day × 8–28 days combined with anti-epileptics and corticosteroids for inflammation control ✓
- D Toxoplasma gondii encephalitis — treat with pyrimethamine plus sulfadiazine
Correct answer: C. Neurocysticercosis (NCC) — treatment with albendazole 15 mg/kg/day × 8–28 days combined with anti-epileptics and corticosteroids for inflammation control
Explanation
Neurocysticercosis (NCC) occurs when humans ingest T. solium eggs (from faecal-oral contamination), acting as accidental intermediate hosts; larvae form cysticerci in the brain. Stool is negative for ova (only positive in intestinal taeniasis from adult worm). Treatment includes albendazole 15 mg/kg/day (or praziquantel 50 mg/kg/day × 15 days) as cysticidal therapy, with concurrent corticosteroids (dexamethasone) to reduce inflammation from dying cysts, and anti-epileptics. MRI shows ring-enhancing cysts, sometimes with scolex (dot in the cyst).
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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