Cysticercosis - An unexpected finding

Case description

An 85-year old women with diabetes mellitus and a history of dementia was admitted to our medical ward with C. difficile colitis, following a previous episode of hospital admission due to a femoral fracture where she underwent antibiotic therapy to treat an infection of the resulting surgical wound. During this episode, abdominal and lower limb radiographs were taken (Fig. A and B), revealing several oval-shaped calcifications within the soft tissues and along the muscle fibres, aspects which are strongly suggestive of musculoskeletal Cysticercosis.

Fig. A.

(Abdominal radiograph) and Figure B (Right Leg radiograph), both showing oval-shaped calcifications (cysticercus;).

There was an accompanying history of abrupt, transient, visual impairment which, together with the aforementioned dementia, prompted an investigation to exclude neurological involvement (not confirmed). We found no larvae in the stools either. The patient passed away due to worsening of her infectious condition and no further testing was conducted.

Cysticercosis is a zoonosis caused by Taenia solium through ingestion of contaminated food products. Estimates point to an incidence of about twenty million new cases per year and around fifty thousand deaths. Embryo from ingested T. solium eggs gain access to the blood stream through the hosts’ intestinal mucosa and disseminate preferentially, through hematogenous spread, to nervous and muscle tissue. This distribution is responsible for the clinical features of the disease, although most of the infections (> 80%) are asymptomatic.

This case highlights the typical radiographic aspects of musculoskeletal cysticercosis, which should prompt additional testing if found.

Ethical considerations

The institution's protocols and procedures were followed regarding consultation and publication of patient data. Written consent was obtained from the patient's family for its publication, and their privacy was respected.

Funding

No funding sources were received.

Conflict of interest

The authors do not declare any conflict of interest.