Neglected rare human parasitic infections: Part II: Coenuriasis Review Article Wael M Lotfy Department of Community Health Nursing, Faculty of Nursing, Matrouh University, Egypt ABSTRACT Taenia multiceps or T. serialis Coenuriasis (also called coenurosis, gid or sturdy) is another neglected parasitic infection that is implicated in human clinical complications. It is a rare zoonotic infection with either . The Keywords:information available in the literature about human infection is scattered and sometimesT. multiceps argumentative., T. serialis Received: Cestoda, coenuriasis,Accepted: coenurus, flatworms, gid, metacestode, staggers, sturdy, Corresponding24 May, Author: 2020, 8 August,Tel.: 2020. E-mail: Print ISSN: OnlineWael M ISSN: Lotfy, +20 1008154959, Vol. 13, No. 2, August,[email protected] 2020. 1687-7942, 2090-2646, Canis familiaris, C. Taenia multiceps or lupus, C. latrans, C. mesomelas, Alopex lagopus T. serialisHuman coenuriasis is a zoonotic parasitic infection domestic Vulpes and vulpes wild canids mainlyNyctereutes procyonoides with a metacestode of either (the arcticFelis (Cestoda: Cyclophyllidea) which is called concolorfox), (fox), and coenurus. Coenuriasis occurs mainly in rodents, (raccoon dog). The parasite[4]Vulpes rarely corsacinfects felids like rabbits, sheep, goats, horses, cattle, and occasionally (cougar, puma) . Experimental infections human (Figure 1). On the other hand, adult worms have been established in [5] (fox), but this develop in the small intestine of some canids causing species was not as susceptible as dogs . Coenuri are taeniasis. However, human cannot be a definitive host found in domesticTheropithecus cattle, sheep, gelada goats, pigs, and many for these species. The intermediate host becomes wild hosts. There are occasional reports[6] of the larvae in infected by ingesting vegetation contaminated with primates like . eggs and/or gravid proglottids of the parasite. In the small intestine, the oncospheres hatch, invade the Infection usually causes morbidity and mortality intestinal wall and migrate mainly to the striated in livestock. After infection of the intermediate host, muscles where they develop into metacestodes called oncosphere larvae penetrate the intestinal wall coenuri (singular coenurus). This metacestode is in and circulate with the blood. In the central nervous the form of a vesicle that contains multiple inverted system, moving larvae leave migratory tracts. Heavy protoscolices, attached to the internal membrane infections may result in acute meningoencephalitis, of the cyst. Daughter cysts may be seen inside some where migratory tracts and encephalitis are visible coenuri. The definitive host becomes infected by at necropsy. A disease variously called gid, sturdy, or ingesting raw or undercooked infected meat. In the staggers usually results from[7] the presence of larvae in host intestine, the metacestode develops into an the central nervous system . Poor motor coordination adult tapeworm, with a prepatent period that varies is quite common. Vision, posture, and gait may be according to the parasite species. Adult worms reside affected. The presence of one coenurus in the cerebral in the small intestine by attachment to the intestinal hemisphere may result in moving of the infected sheep wall. After maturity and fertilization, eggs or gravid in circles in a direction opposite to the side of the proglottids are[1] passed in the host’s faeces to complete brain in which the larva is located. The presence of the life cycle . Coenuriasis occurs very rarely in the larvae in the spinal cord may cause paralysis of the humans, and many cases probably [2]existed years hindquarters. In infected sheep, depression,[8,9] anorexia, before it was recognized or discovered . This review emaciation, and death are not uncommon . summarizes current knowledge on the biology and public health significance of human coenurosis, and Although, theT. parasitemulticeps cannot be transmitted to 1-the Taenia recommended multiceps methods (Leske, of 1780) prevention Versteer, and control. 1967 man from the intermediate hosts, the meat infected Synonyms: with coenuri of is considered suitable for human consumption if only a few cysts are present and Coenurus Multicepscerebralis multiceps (Leske, 1780) if they are removed; but, if many coenuri are present in Hall, 1919; M. gaigeri Hall, 1916; M. skrjabini Popov, the meat the entire carcass[10] should be judged unsuitable 1937; (Batsch, 1786) Rudolphi, for human consumption . The first identified human 1808. infection was in Paris in 1913. A man was suffering from loss of ability to speak and understandT. multiceps speech, This cestode [3,4]has a wide distribution especially in convulsions, and aphasia. His autopsy revealed two Europe and Asia . It has a well-established pastoral coenuri in the brain, most probably ; life cycle in dogs and domestic livestock and a sylvatic one was[11] degenerated and the other contained 75 cyclePersonal in non-commercialwild canids anduse only. wild PUJ herbivores. copyright © 2020. It colonizes All rights reserved scolices . Subsequently, DOI: more 10.21608/puj.2020.30935.1074 human cases of 72 Coenuriasis Lotfy , , Asia [12,13] cerebral[14-17] coenuriasis[2,18-20] were reported from[21-26] Africa distributionT. whiles. serialis the latter is present exclusively in Europe and the Americas . Coenuri Africa. Adult worms of both subspecies colonize canids.T. s. were reported mainly in the submeningeal cortex. brauniCoenuri of were reported from lagomorphs They were in the form of cysts that grow and compress and, less frequently, rodents, while coenuri of[28] the surrounding tissue. However, coenuri have been were reported from rodents and primates . less frequently found[2,25] within the cerebral parenchyma due to T. s. serialis and the spinal cord . The most common symptoms The first authenticated case of human coenuriasis of human cerebral coenuriasis include headaches, was reported in a 59-year-old vomiting, and papilloedema that are related to the French woman by Bonnal and colleagues in 1933. The increased intracranial pressure caused by the mass coenurus that had been growing under her skin was effect of the cystic lesion. Focal neurological deficit, extracted from her subcutaneous tissue and fed to a such as cranial[20] nerve palsy and motor disturbances are dog. Seven characteristic[29] scolices were collectedT. multiceps later also frequent . In more than 50% of the human cases, from the dog . Thereafter,[30,31] more human cases were cysts are sterile (without protoscolices) which makes reported in Europe . It is believed that diagnosis difficult. Apart from imaging techniques, there was imported into North America, and currently[3] it is is no clinical way of differentiating cerebral coenuriasis[27] no longer present or at least uncommonT. s. serialis there . Cases 2-from Taenia cases ofserialis cysticercosis (Gervais, or echinococcosis 1847) Baillet,. 1867 of human cerebral coenuriasis that wereT. reported s. serialis from are sensu lato North America[25] may be caused by that is Synonyms: enzootic there . The cystic larvae of T. s. serialis usually found in the subcutaneous and intramuscular Coenurus serialis Gervais, 1847; tissues. Experimental infection[32] T.with s. serialis Multiceps serialis (Gervais, 1847) Stiles et Stevenson produced CNS involvement , and at least one case 1905. T. s. serialis and T. s. brauni of fatal infection caused by the [33] larva in In 1969, Verster divided this species into two the brain of a cat has been described . Also, cases of subspecies: . Identification of infection[24,34,35] without a CNS involvement were reported in each was based on biological rather than morphological USA . characters. The former subspecies has a cosmopolitan Coenurosis (8) (7) Conuri develop in various tissues (common in theDiagnostic brain, eyes, stage. and (6) Onchospheres hatch, subcutaneous tissue. penetrate intestinal wall, Embryonated eggs and circulate to tissue. ingested by human. Coenurosis (3) Onchospheres hatch, penetrate intestinal wall, Onchospheres develop into coenuri (4) and circulate to tissue. containing many protoscolices within the tissue of the intermediate host. Canid definitive host becomes infected by ingesting intermediate host Taenia multiceps Taenia serialis (2) (5) Embryonated eggs and/ or gravidInfective proglottids stage ingested Adult in small intestine by the intermediate host. (1) Eggs or gravid proglottids in Fig 1. T. multiceps and T. serialis feces and passed into environment. Life cycles of , and transmission of human coenuriasis (www.cdc.gov) with modifications 73 PARASITOLOGISTS UNITED JOURNAL Taenia s. brauni REFERENCES [36-38] is endemic in animals exclusively Taenia in Africa . TurnerCoenurus and glomerulatusLeiper in 1919, reported a human infection in Nigeria with a coenurus[39] which 1. Hoberg EP. tapeworms: their biology, evolution they identified as , a parasite and socioeconomic significance. Microbes Infect. which was describedT. s. braun [40]previously in gerbils by Railliet 2002;4:859-866. and Henry in 1915 . However, this coenurusT. iss. 2. TaeniaBenifla M,multiceps Barrelly R, Shelef I, El-On J, Cohen A, Cagnano braunidentical with[41] i and is therefore considered E. Huge hemispheric intraparenchymal cyst caused by a synonym . Many human cases infected with in a child. Case report. J Neurosurg i were reported in Tropical Africa. Mainly from 2007;107(6Coenurus Suppl):511-514. cerebralis (= Taenia multiceps Burundi, Kenya, Rwanda, Nigeria,