Isolated Medial Rectus Cysticercosis mimicking pre-septal cellulitis: A Case Report
Abstract
Man is the intermediate host in the life cycle of the pork tapeworm Taenia solium. Its larval form Cysticercus cellulosae is the causative agent of cysticercosis. Both intraocular and extra ocular cysticercosis is observed in tropical countries like India. A case of extra ocular cysticercosis is reported here. An eight year old female patient who was brought to emergency department with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye. CT scan showed scolex of Taenia solium in left medial rectus muscle. The patient recovered completely with oral albendazole steroids for four weeks. So a case with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye should be investigated for cysticercosis.
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Introduction
Cysticercosis is the most common parasitic disease of the nervous system1 caused by Cysticercus cellulosae, the larval form of Taenia solium. Man gets infested by accidental ingestion of Taenia solium eggs, through faecally contaminated water or food or under cooked pork and man acts the intermediate host for that.2 Cysticercus cellulosae could be found in encysted form in various body tissues, including the eyes, central nervous system (CNS), and subcutaneous tissues. Ocular cysticercosis is known to be endemic in tropical region of sub-Saharan Africa, India and East Asia.3 In ocular cysticercosis, the most common site of involvement is reported to be vitreous and sub-retinal tissue, 4 while extra ocular muscle cysticercosis is less common.
Conclusion
Cysticercosis is a common clinical condition in developing countries like India. It can even involve the eye and its surrounding structures and clinical presentation can vary depending upon structure involved. Extraoccular cysticercosis should be kept in the early differential diagnosis of space occupying lesion of orbit as delay in diagnosis can lead to loss of vision. USG and CT are accurate tools for diagnosis and Albendazole is an effective treatment for orbital cysticercosis.