Discrepancies Between Cerebral Computed Tomography and Western Blot in the Diagnosis of Neurocysticercosis

Hector H. Garcia Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Genaro Herrera Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Robert H. Gilman Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Victor C. W. Tsang Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Joy B. Pilcher Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Jose F. Diaz Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Errol J. Candy Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Elba Miranda Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Jorge Naranjo Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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The Cysticercosis Working Group in Peru (Clinical Studies Coordination Board)* Universidad Peruana Cayetano Heredia, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Neuroradiology, Johns Hopkins Hospital, Lima, Peru

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Serum samples from sequential patients who underwent cerebral computed axial tomography (CT) scan in a Peruvian radiologic clinic were tested by the highly sensitive and specific enzyme-linked immunoelectrotransfer blot (EITB) test to detect antibodies to Taenia solium. The results of the EITB test were compared with those obtained by CT scan for the diagnosis of neurocysticercosis. Of the 383 patients sampled, 32 (8%) were seropositive. The results of CT and EITB were frequently discrepant. When compared with the EITB assay, the CT scan was 44% sensitive and 95% specific. The sensitivity of CT increased to 63% if less specific images (single calcifications, granulomas, or hydrocephalus) were included. The CT scan for diagnosis of cysticercosis can best be used in conjunction with a reliable serologic test such as the EITB.

Author Notes

The other members of the Cysticercosis Working Group in Peru are P. Torres, C. Gallo, C. Carcamo, M. Verastegui, T. Montenegro, M. Alvarez (Universidad Peruana Cayetano Heredia); C. Evans (Cambridge University, UK); A. E. Gonzales (Universidad Nacional Mayor de San Marcos); M. Castro, A. Guerron (A B PRISMA); M. Martinez, M. Porras, M. Alvarado, E. Orrillo, L. Palomino, G. Alban, L. Calagua, S. Escalante, L. Trelles, O. Aliaga, N. Rios-Saavedra, M. Velarde, J. M. Cuba, H. Estrada, M. Soto, L. Portilla (Instituto Nacional de Ciencias Neurologicas); A. Terashima, J. Cabrera, P. Campos (Hospital Cayetano Heredia); D. Morote (Hospital Edgardo Rebagliati); U. Rocca (Hospital Guillermo Almenara).

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