Cause: Echinococcus granulosusand multilocularis(hydatid cyst); sometimes T. solium(see above)
Pathophys:Like a neoplasm, echinococcal cysts grow over years with appearance of secondary cysts
Humans are only intermediate host, ie, do not spread eggs in stool, rather only have encysted organisms
Lab:
CSF:in cysticercosis: aseptic picture with low sugar; eosinophils
Serol: IHA titers increased (from CDC) are pos in 90% with liver, 75% with lung involvement
Rx:
Albendazole 5 mg/kg po tid × 28-56 d + either surgical or percutaneous drainage (Nejm 1997;337:881)
for T. soliumcysticercosis: surgical excision; albendazole as above or praziquantel + dexamethasone (Nejm 1984;311:1492); in cerebral cysticercosis, rx only w albendazole 800 mg + dexamthasone 6 mg po qd × 10 d, not seizure meds (Nejm 2004;350:249)