Treatment Outcome in Patients with Disseminated Cysticercosis: A Systematic Review of Case Reports and Case Series

被引:3
|
作者
Garg, Ravindra Kumar [1 ]
Rizvi, Imran [1 ]
Chakravarty, Rajarshi [1 ]
Malhotra, Hardeep Singh [1 ]
Kumar, Neeraj [1 ]
机构
[1] King Georges Med Univ, Dept Neurol, Lucknow 226003, India
来源
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE | 2024年 / 110卷 / 06期
关键词
NEUROCYSTICERCOSIS; DIAGNOSIS;
D O I
10.4269/ajtmh.23-0694
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Disseminated cysticercosis is defined by multiple brain lesions and involvement of other body sites. Cysticidal treatment in disseminated cysticercosis is considered life -threatening. We conducted a systematic review of all published cases and case series to assess the safety and efficacy of cysticidal treatment. We conducted a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta -Analyses (PRISMA) guidelines (PROSPERO CRD42022331895) to assess the safety and efficacy of cysticidal treatment. Using the search term "disseminated neurocysticercosis OR disseminated cysticercosis," databases like PubMed, Scopus, Embase, and Google Scholar were searched. Outcomes included death and secondary measures like clinical improvement and lesion reduction. We calculated the predictors of primary outcome (death) using the binary logistic regression analysis. We reviewed 222 published cases from 101 publications. Approximately 87% cases were reported from India. Of 222 cases, 134 (60%) received cysticidal treatment. Follow-up information was available from 180 patients, 11 of them died, and 169 showed clinical improvement. The death rate was 4% (5 out of 114) in patients treated with cysticidal drugs plus corticosteroids, in comparison with 13% (5 out of 38) in patients who were treated with corticosteroids alone. All patients using only praziquantel faced fatality. Death predictors identified were altered sensorium and lack of treatment with albendazole. We noted that the risk of death after cysticidal treatment is not as we expected, and a multicentric randomized controlled trial is needed to resolve this issue.
引用
收藏
页码:1080 / 1088
页数:9
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