Taeniasis and neurocysticercosis among Malaysians

Taeniasis, endemic in Southeast Asia, is caused by Taenia saginata (for beef) or Taenia solium and Taenia asiatica (for pork). T. solium also causes cysticercosis which can affect various organs. Taeniasis and cysticercosis cases are rarely reported in Malaysia. We report here two separate cases of beef taeniasis, and an interesting case of neurocysticercosis in a Malay Muslim. The taeniasis cases involved a Malaysian Chinese and a native Sabahan. Proglottids were recovered from them, and identification of the tapeworm done either from the microscopic examination of the egg or using PCR-based molecular diagnosis. Upon confirmation of taeniasis, both cases were given praziquantel and had been asymptomatic since. The neurocysticercosis case involving a Muslim who presented with seizure, was confirmed by histopathological examination of tissue sections taken from craniotomy excision of the brain lesion. He was given one month course of albendazole 400 mg bid and dexamethasone, and had been well and seizure free since. The two cases of taeniasis documented here had acquired the disease through eating raw or undercooked contaminated beef. For the neurocyticercosis case, it is suspected that he might have acquired the infection in one of his travels through human to human transmission via contaminated food or water consumption, given that Malaysia is not T. solium endemic area. Lastly praziquantel is an effective drug for beef taeniasis, while a combination of albendazole and dexamethasone work well for neurocysticercosis.