Reliability of Diagnostic Criteria for Neurocysticercosis for Patients with Ventricular Cystic Lesions or Granulomas: A systematic review

Javier A. Bustos Department of Microbiology, Center for Global Health – Tumbes, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Hector H. García Department of Microbiology, Center for Global Health – Tumbes, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;
Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Oscar H. Del Brutto School of Medicine, Universidad Espíritu Santo – Ecuador, Guayaquil, Ecuador

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Intraventricular neurocysticercosis (NCC) is a severe form of NCC requiring prompt diagnosis and treatment. We aimed to assess the reliability of the most recent version of diagnostic criteria for this form of NCC. Two systematic literature reviews were performed; one included case reports of patients with intraventricular cysticercosis and the other included case reports of patients with intraventricular cystic lesions or granulomas caused by infections other than NCC. All assessed cases were categorized according to the last revision of the long-standing Del Brutto’s set of diagnostic criteria to determine its sensitivity, specificity, and predictive value for this form of NCC. The search disclosed 128 patients with intraventricular NCC and 41 with other infections. The set of diagnostic criteria classified as definitive NCC 93 cases with intraventricular NCC (sensitivity 72.7%, 95% CI, 63.9–79.9%), as well as four cases with other infections (specificity 90.2%, 95% CI, 75.9–96.8%). The positive and negative predictive values of the criteria were 0.96 (95% CI, 0.89–0.99) and 0.51 (95% CI, 0.39–0.63), respectively. The revised Del Brutto’s set of diagnostic criteria for NCC is acceptably sensitive and highly specific for diagnosing patients with the ventricular form of the disease.

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Author Notes

Address correspondence to Oscar H. Del Brutto, Air Center 3542, PO Box 522970, Miami, FL 33152-2970. E-mail: oscardelbrutto@hotmail.com

These authors contributed equally to this work.

Financial support: J. A. B. is partially supported by FIC-NIH grant TW001140 and O. H. D. is supported by Universidad Espíritu Santo – Ecuador.

Authors’ addresses: Javier A. Bustos, Universidad Peruana Cayetano Heredia, Center for Global Health, Lima, Peru, E-mail: javier.bustos@jhu.edu. Hector H. García, Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Centro de Salud Global Tumbes, Lima, Peru, E-mail: hgarcia1@jhu.edu. Oscar H. Del Brutto, Hospital-Clinica Kennedy, School of Medicine, Universidad Espiritu Santo – Ecuador, Guayaquil, Ecuador, E-mail: oscardelbrutto@hotmail.com.

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