PROPOSAL OF DIAGNOSTIC-CRITERIA FOR HUMAN CYSTICERCOSIS AND NEUROCYSTICERCOSIS

Taenia solium cysticercosis is a major public health problem in severa l areas of the world. While the disease has a recognized etiologic age nt, its definitive histological diagnosis is not possible in most case s because this parasite tends to lodge in cerebral tissues where routi ne biopsy is not feasible. Therefore, the diagnosis of human cysticerc osis (and neurocysticercosis) should rest on the proper interpretation of the patients' symptoms together with data provided by radiological studies and immunologic tests for the detection of anticysticercal an tibodies. Unfortunately, the pleomorphism of this parasitic disease cr eates confusion when non-specific clinical, radiological, or immunolog ic criteria alone are used to detect cases among populations or to dia gnose hospitalized patients with neurological manifestations. We propo se a chart of diagnostic criteria for human cysticercosis that objecti vely permit clinicians and health care workers to evaluate clinical, r adiological, immunologic, and epidemiologic data of patients. The char t uses four degrees of criteria: absolute, major, minor, and epidemiol ogic, that were selected on the basis of their individual diagnostic s trength. Interpretation of such criteria will result in three categori es of diagnostic certainty: definitive, probable and possible, accordi ng to the likelihood that cysticercosis is present in a given person.