Cysticercosis - tissue infestation by tapeworm larvae

Cysticercosis is an infection with the larvae of the pork tapeworm, which can affect organs such as the brain, muscles or skin. Find out more about symptoms, treatment and protective measures here.

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Cysticercosis is an infection with the larvae of the pork tapeworm, which can affect organs such as the brain, muscles or skin. Find out more about symptoms, treatment and protective measures here.

The cysticercosis is a parasitic infection of humans with the larvae (fins) of the pork tapeworm (Taenia solium). In contrast to classic intestinal infestation (taeniasis), in which the worm develops in the small intestine, in cysticercosis the worm eggs enter the body and develop outside the intestine - for example in the muscle tissue, subcutaneous tissue, brain or eye. Particularly feared is neurocysticercosis, i.e. the infestation of the central nervous system, which can lead to neurological symptoms and serious complications.

Infection occurs through oral ingestion of pork tapeworm eggs, e.g. via faecally contaminated food or water, contaminated hands or poor hygiene. The larvae hatch in the intestine, penetrate the intestinal wall and migrate via the bloodstream to other organs, where they develop into cysts (cysticerci. Depending on their location, these cause symptoms of varying severity - from painless lumps in the skin to cramps, headaches or neurological deficits in the case of brain infestation.

Diagnosis is made depending on the form via imaging (CT, MRI), serological tests, muscle biopsies or stool examinations in the case of concomitant taeniasis. Treatment depends on the number, localisation and symptoms. It includes antiparasitic medication (e.g. albendazole, praziquantel), anti-inflammatory agents (e.g. corticosteroids) and, if necessary, antiepileptic therapy for neurocysticercosis. In severe cases, surgical removal of cysts is necessary. Cysticercosis is a frequent cause of epileptic seizures, particularly in tropical countries with poor sanitation and hygiene.

Causes and routes of transmission:

Ingestion of Taenia solium eggs via contaminated food or water
Smear infections due to poor hygiene
Autoinfection with existing taeniasis (e.g. due to reflux of eggs into the stomach)
Common in regions with high pig farming and inadequate sanitary infrastructure

Symptoms of cysticercosis:

Neurocysticercosis: Headaches, seizures, dizziness, cognitive disorders
Muscular cysticercosis: Knots, pain, muscle hardening
Subcutaneous cysticercosis: palpable skin nodules, usually painless
Eye cysticercosis: Visual disturbances, eye movement disorders
General symptoms: Fever, weakness, weight loss

Treatment options:

Albendazole or praziquantel (parasite-killing)
Corticosteroids to control the inflammatory response
Anticonvulsants for epileptic seizures
Surgical removal of large or dangerous cysts
Combination therapy for multiple organ involvement

Prevention:

No consumption of raw pork
Consistent hand and kitchen hygiene
Drink sterile water in risk areas
Control of taeniasis in the population with anthelmintics

Literature references:

Garcia, H. H. et al. (2014). ""Neurocysticercosis: Updated Concepts about an Old Disease."" Lancet Neurology.
WHO (2022). ""Taeniasis and Cysticercosis - Key Facts.""
Robert Koch Institute (2023). ""Cysticercosis: Epidemiology and prevention.""