Case Report

Cerebellar Neurocysticercosis as Long-Term Complication of Allogeneic Haematopoietic Stem Cell Transplantation from Haploidentical Donor

Table 1

Revised diagnostic criteria by Del Brutto et al. [3].

Categories of criteriaCriteria

Absolute(i) Histological demonstration of the parasite from biopsy of a brain or spinal cord lesion
(ii) Visualization of subretinal cysticercus
(iii) Conclusive demonstration of a scolex within a cystic lesion on neuroimaging studies

NeuroimagingMajor neuroimaging criteria
(i) Cystic lesions without a discernible scolex
(ii) Enhancing lesionsa
(iii) Multilobulated cystic lesions in the subarachnoid space
(iv) Typical parenchymal brain calcificationsa
Confirmative neuroimaging criteria
(i) Resolution of cystic lesions after cysticidal drug therapy
(ii) Spontaneous resolution of single small enhancing lesionsb
(iii) Migration of ventricular cysts documented on sequential neuroimaging studiesa
Minor neuroimaging criteria
(i) Obstructive hydrocephalus (symmetric or asymmetric) or abnormal enhancement of basal leptomeninges

Clinical/exposureMajor clinical/exposure
(i) Detection of specific anticysticercal antibodies or cysticercal antigens by well-standardized immunodiagnostic testsa
(ii) Cysticercosis outside the central nervous systema
(iii) Evidence of a household contact with T. solium infection
Minor clinical/exposure
(i) Clinical manifestations suggestive of neurocysticercosisa
(ii) Individuals coming from or living in an area where cysticercosis is endemica
Definitive diagnosis
(i) One absolute criterion
(ii) Two major neuroimaging criteria plus any clinical/exposure criteria
(iii) One major and one confirmative neuroimaging criteria plus any clinical/exposure criteria
(iv) One major neuroimaging criteria plus two clinical/exposure criteria (including at least one major clinical/exposure criterion) together with the exclusion of other pathologies producing similar neuroimaging findings
Probable diagnosis
(i) One major neuroimaging criteria plus any two clinical/exposure criteria
(ii) One minor neuroimaging criteria plus at least one major clinical/exposure criteria

aOperational definitions. Cystic lesions: rounded, well-defined lesions with liquid contents of signal similar to that of the CSF on CT or MRI; enhancing lesions: single or multiple, ring- or nodular-enhancing lesions of 10–20 mm in diameter, with or without surrounding edema, but not displacing midline structures; typical parenchymal brain calcifications: single or multiple, solid, and most usually <10 mm in diameter; migration of the ventricular cyst: demonstration of a different location of ventricular cystic lesions on sequential CTs or MRIs; well-standardized immunodiagnostic tests: so far, antibody detection by the enzyme-linked immunoelectrotransfer blot assay using lentil lectin-purified T. solium antigens, and detection of cysticercal antigens by monoclonal antibody-based ELISA; cysticercosis outside the central nervous system: demonstration of cysticerci from biopsy of subcutaneous nodules, X-ray films, or CT showing cigar-shaped calcifications in soft tissues, or visualization of the parasite in the anterior chamber of the eye; suggestive clinical manifestations: mainly seizures (often starting in individuals aged 20–49 years; the diagnosis of seizures in this context is not excluded if patients are outside of the typical age range), but other manifestations include chronic headaches, focal neurologic deficits, intracranial hypertension, and cognitive decline; cysticercosis-endemic area: a place where active transmission is documented. bThe use of corticosteroids makes this criterion invalid.