Dept Paediatrics & Child Health, Red Cross War Memorial Children’s Hospital, and SA-MRC Unit on Child & Adolescent Health, UCT, SA
To the Editor : Cysticercosis in humans is a serious public health problem, predominantly affecting low and middle-income countries (LMICs) (1, 2). Cysticercosis, the infection with the larval form of the pork tapeworm, Taenia Solium has high prevalence in areas where there are poor sanitary conditions and domestic pig without adequate veterinary control(1). Humans are the definitive host and pigs are the main source of infection. Human infection occurs when pork is eaten raw or undercooked. Ingested eggs or proglottids hatch into larvae form, which penetrate the intestinal wall into the blood stream and migrate into different organs including subcutaneous tissues, brain, eyes and rarely heart or lung, where they mature into cysticerci(3). Pulmonary cysticercosis has been rarely described; case reports are predominantly in adults and are usually of disseminated disease. In children the data are very scarce, with a single case report of a two-year old child with pulmonary infiltration, eosinophilia and subcutaneous cysticercosis (3).
We describe an 8-year-old child with pulmonary cysticercosis who presented to Red Cross Children’ s Hospital, Cape Town, South Africa, with a large right pleural effusion. She presented with five days of cough, fever and shortness of breath. She resided in a poor informal settlement, in an urban area of Cape Town and had no recent travel history or underlying illness. She had no direct contact with pigs, although consumed pork. There was no known household or close contact with tuberculosis (TB). On examination she was well nourished, with a temperature of 38 degrees Celsius, respiratory rate of 36 breaths per minute and oxygen saturation of 96 % in room air. She had mild subcostal chest retractions, tracheal deviation to the left side with dullness to percussion and reduced breath sounds on the right chest.
Chest x-ray showed complete opacification of the right hemithorax and mediastinal shift to the left, fig 1.
Fig 1: Frontal chest Xray showing opacification of the right hemithorax, and mediastinal shift to the left.