1 - Pediatria Médica, Área de Pediatria Médica, Hospital Dona Estefânica, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal
2 - Unidade de Infeciologia, Área de Pediatria Médica, Hospital Dona Estefânica, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal
3 - Unidade de Neurologia Pediátrica, Área de Pediatria Médica, Hospital Dona Estefânica, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal
4 - Unidade de Radiologia, Hospital Dona Estefânica, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal
- Paediatrics Infectious Diseases Congress 2023
Introduction: Neurocysticercosis (NCC) is a neglected tropical disease, representing one of the leading treatable causes of seizures in endemic areas. In Portugal is not a statutory notifiable disease. Our aim is to characterize the clinical features of children with NCC, admitted to a paediatric hospital.
Methods: Retrospective observational study of paediatric patients (0-17 years old) with NCC, admitted to a tertiary-level hospital in Portugal, over a thirteen-year period (2010-2022).
Results: Fifteen children with NCC were identified (median age 8 [4-14], 10/15 males). According to Del Brutto criteria, 7/15 were considered definitive and 4/15 probable diagnosis. 12/15 had a recent history of travel to an endemic area (Cape Verde and Guinea-Bissau). All patients presented with neurological symptoms at diagnosis, mostly seizures (13/15) and headache (5/15). Diagnostics were made by neuroimaging: 2/15 had viable lesion, 11/15 single enhancing lesion and 5/15 calcification. No serological serum studies or parasitological examination of feces were positive. Patients with more than a lesion (n=3) were treated with anthelmintics (two with albendazole, one with albendazole and praziquantel) and corticosteroid therapy. 13/15 were treated with antiepileptic drug, in monotherapy. On clinical follow-up at six months, only one patient had symptoms (seizures). The median time for repeating image was six months and all showed improved lesions, 7/10 being calcified.
Conclusions: NCC can cause preventable severe neurologic disease. Treatment with anthelmintic and corticosteroid therapy are crucial to improve prognosis. OMS (2022) has different recommendations for treatment we should apply in the future. Our cases were mainly imported from endemic regions, but local transmission also occurred, probably in the setting of a tapeworm carrier in the household. Indeed, NCC is an important public health problem that should not be neglected also in developed countries.
Palavras Chave: children, neurocysticercosis, public health, seizures, treatment