School of Medicine, Universidad de Especialidades Espíritu Santo, and Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
Pediatr Neurol. 2013 Jun;48(6):432-5. doi: 10.1016/j.pediatrneurol.2013.02.001.
Neurocysticercosis in infants and toddlers has received little attention in the literature, and little is known about the mechanisms of disease acquisition and clinical forms of presentation of the disease in this age group. All patients aged ≤3 years with neurocysticercosis evaluated at Hospital-Clínica Kennedy, Guayaquil, over a 22-year period were included in this study. Their household contacts were screened to detect Taenia solium carriers, which may represent the source of infection. A literature search on neurocysticercosis in infants and toddlers was also performed to compare personal cases with those described elsewhere. A total of 25 infants and toddlers with neurocysticercosis were included (seven from our institution and 18 from the literature). All patients had seizures as the primary manifestation of the disease, and neuroimaging studies showed one or two parenchymal brain cysticerci in the colloidal stage in 88% of patients. The source of infection was investigated in 11 houses, including the seven households of the present series, and only four of the 18 reported in the literature. A Taenia carrier was found in five (45%) of these households, including three from the present series and two from the literature. A sizable proportion of infants and toddlers with neurocysticercosis have been infected at home. Compulsory search of Taenia carriers among household contacts will allow the detection of the potential source of infection and will reduce further spread of the disease. The search must not be limited to family members, but also extended to domestic employees who are in daily contact with the children.
婴儿和幼儿的神经囊虫病在文献中很少受到关注,对于该年龄段疾病的发病机制和临床表现形式知之甚少。本研究纳入了在基多肯尼迪医院就诊的所有年龄≤3 岁的神经囊虫病患者。对这些患者的家庭接触者进行筛查,以发现可能的感染源——带绦虫病患者。此外,还对婴儿和幼儿神经囊虫病的文献进行了检索,以将个人病例与其他地方描述的病例进行比较。共纳入了 25 例神经囊虫病婴儿和幼儿(7 例来自我们医院,18 例来自文献)。所有患者的主要表现均为癫痫发作,88%的患者神经影像学检查显示胶体期有 1 或 2 个脑实质囊虫。在 11 户家庭中调查了感染源,包括本研究的 7 户家庭和文献报道的 18 户家庭中的 4 户。在这些家庭中发现了 5 例(45%)带绦虫病患者,包括本研究中的 3 例和文献中的 2 例。相当一部分婴儿和幼儿的神经囊虫病是在家中感染的。必须对家庭接触者中的带绦虫病患者进行强制性搜索,以发现潜在的感染源,并减少疾病的进一步传播。搜索范围不应仅限于家庭成员,还应扩展到与儿童有日常接触的家庭佣工。