Cysticercosis of the central nervous system and cerebrospinal fluid immunodiagnosis of 1573 patients in 63 years (1929-1992)

Attention given to prophylaxis of neurocysiticercosis (NC) is far beyond minimal needs among several regions of the in-development world, and for this reason incidence of the disease persists high among them. This investigation was carried out to show the extent of the problem by analysing the incidence of NC in a region of Brazil (São Paulo). CSF immunodiagnosis of NC by detecting antibodies to Cysticercus cellulosae in a neurodiag-nostics laboratory is evaluated for this purpose. Cases studied in a 63-year period (1929-1992) are reviewed. Total cases in this period is 139,000, and for 1,573 (1.13%) diagnosis is NC. Special characteristics were not detected for colour and sex prevalence. Age bracket prevalence is from 21 to 40 years old (55.3%) high rates occurring for women between 21 to 30 years old, and for men between 31 to 40. Cases distribution in five consecutive decades (1942-1991) shows no decreasing tendency: average incidence is 1% for the 50 years, and it is over this average for the last three decades. Data confirm that incidence continues expressively high throughout the 50 years covered by this study

Erythro-lectin Immuno Test (erythro-lit) In The Immunodiagnosis Of Neurocysticercosis.

1. The effectiveness of the Erythro-Lectin Immuno Test (Erythro-LIT) to detect anticysticercus antibodies was tested using cerebrospinal fluid (CFS) from patients with neurocysticercosis. 2. Both Erythro-LIT and complement fixation (CF) were used to detect antibodies in 36 CSF samples from cysticercotic patients. Erythro-LIT detected anticysticercus antibodies in 35 CSF samples (97%) and CF in 26 (72%). The antibody titers ranged from 1:4 to 1:4096 for Erythro-LIT (mean geometric titer = 282.65) and 1:1 to 1:64 in CF (mean geometric titer = 7.92). 3. When greater than or equal to 1:16 Erythro-LIT titer was used as a significant diagnostic cut-off value, the sensitivity and specificity of Erythro-LIT were 92% and 100%, respectively, for CFS. 4. The high sensitivity and specificity demonstrated here, together with the simplicity and low cost of the test, make the Erythro-LIT a potentially useful method for screening for specific antibodies in neurocysticercosis.221697

Histoplasmose do sistema nervoso central aspectos clínicos em oito pacientes: clinical features in eight patients

Foram estudados oito pacientes com histoplasmose do sistema nervoso central, nenhum deles com sinais clínicos ou laboratoriais de imunodepressão. O tempo de doença por ocasião do diagnóstico variava entre 6 e 108 meses (mediana 36 meses). Principais sinais e sintomas encontrados: síndrome de hipertensão intracraniana, em 6 pacientes; déficit de memória, em 4; confusão mental, em 4; convulsões, em 2; paraparesia ou paraplegia crural, em 2; incontinência urinária, em 2; impotência sexual, em 1. A forma meningoencefalítica foi encontrada em 6 pacientes e a granulomatosa, em 2. O diagnóstico foi feito: por biópsia em 1 caso; por necrópsia, em 2; através de cultura do sedimento do LCR em meio de Sa-bounaud, em 1; através da detecção de anticorpos a, Histoplasma capsulatum no LCR, em 5. Foi observada profunda discrepância entre as alterações detectadas ao exame de LCR (intensas, com elementos de fase aguda mesclados a elementos de fase crônica) e o quadro clínico por ocasião do diagnóstico (pacientes em geral oligossintomáticos)