{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:11:26Z","timestamp":1780499486780,"version":"3.54.1"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Neurocysticercosis (NCC) is a cestode infection of the central nervous system caused by the larval form of\n                    <jats:italic>Taenia solium<\/jats:italic>\n                    . Diagnosis is often delayed because of low health care provider awareness of the disease. This study evaluated contemporary provider practices within a large county health care system in the United States. We retrospectively identified adult patients with NCC between 2017 and 2021 through the International Classification of Diseases 10 diagnostic code and extracted variables from their electronic medical records using a standardized data collection form. We compared provider actions with those recommended by the 2017 Infectious Disease Society of America (IDSA) NCC guidelines. Of 174 patients identified, 113 met definitive or probable criteria for NCC diagnosis. Most were Hispanic, from Mexico, and living in the United States for more than 5 years. Fifty-four (48%) had calcified lesions, and 59 (52%) had viable lesions, including 26 with extraparenchymal NCC. Although all patients underwent neuroimaging, many (\n                    <jats:italic>n<\/jats:italic>\n                    = 44, 39%) did not undergo both magnetic resonance imaging and computed tomography of the head. Few patients underwent gold-standard confirmatory serology. Twenty-four percent (\n                    <jats:italic>n<\/jats:italic>\n                    = 8) of patients with viable parenchymal NCC and 80% (\n                    <jats:italic>n<\/jats:italic>\n                    = 21) of patients with extraparenchymal NCC were not treated according to IDSA guidelines or were untreated. To address the gaps identified by our research, future work should include implementation of medical education strategies to improve knowledge of NCC diagnostic and management practices among frontline health care providers serving at-risk U.S. communities.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0304","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T14:44:33Z","timestamp":1775745873000},"page":"1165-1171","source":"Crossref","is-referenced-by-count":0,"title":["Improving Neurocysticercosis Diagnosis: Neurocysticercosis Diagnostic Practices at a Large Public Hospital System in Texas"],"prefix":"10.4269","volume":"114","author":[{"given":"Theresa","family":"Sepulveda","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Infectious Disease and Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando H.","family":"Centeno","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Serpa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Diseases, University of Texas Tyler School of Medicine, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Weatherhead","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Disease and Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva H.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Disease and Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Microbiol Rev","first-page":"e00085-19","article-title":"Taenia solium cysticercosis and its impact in neurological disease","volume":"33","author":"Garcia","year":"2020"},{"key":"b2","series-title":"Adv Parasitol","first-page":"133","article-title":"Taenia solium taeniasis\/cysticercosis: From parasite biology and immunology to diagnosis and control","volume":"112","author":"Dixon","year":"2021"},{"key":"b3","article-title":"WHO Guidelines on Management of Taenia solium Neurocysticercosis","year":"2021"},{"key":"b4","article-title":"WHO Estimates of the Global Burden of Foodborne Diseases: Foodborne Disease Burden Epidemiology Reference Group 2007\u20132015.","year":"2015"},{"key":"b5","series-title":"Am J Trop Med Hyg","first-page":"354","article-title":"Cysticercosis-related hospitalizations in the United States, 1998\u20132011","volume":"92","author":"O\u2019Keefe","year":"2015"},{"key":"b6","series-title":"Emerg Infect Dis","first-page":"2168","article-title":"Evaluating healthcare claims for neurocysticercosis by using all-payer all-claims data, Oregon, 2010\u20132013","volume":"22","author":"Flecker","year":"2016"},{"key":"b7","series-title":"Microorganisms","first-page":"1221","article-title":"A large case series of neurocysticercosis in Kuwait, a nonendemic Arabian Gulf country in the Middle East region","volume":"9","author":"Iqbal","year":"2021"},{"key":"b8","series-title":"Emerg Infect Dis","first-page":"1","article-title":"Public health implications of cysticercosis acquired in the United States","volume":"17","author":"Sorvillo","year":"2011"},{"key":"b9","series-title":"Emerg Infect Dis","first-page":"969","article-title":"Hospitalization frequency and charges for neurocysticercosis, United States, 2003\u20132012","volume":"21","author":"O\u2019Neal","year":"2015"},{"key":"b10","series-title":"Open Forum Infect Dis","first-page":"ofae176","article-title":"Subarachnoid neurocysticercosis case series reveals a significant delay in diagnosis-requiring a high index of suspicion among those at risk","volume":"11","author":"Beatty","year":"2024"},{"key":"b11","series-title":"Am J Trop Med Hyg","first-page":"945","article-title":"Diagnosis and treatment of neurocysticercosis: 2017 Clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"98","author":"White","year":"2018"},{"key":"b12","series-title":"J Neurol Sci","first-page":"202","article-title":"Revised diagnostic criteria for neurocysticercosis","volume":"372","author":"Del Brutto","year":"2017"},{"key":"b13","series-title":"J Clin Microbiol","first-page":"e00424-18","article-title":"Laboratory diagnosis of neurocysticercosis (Taenia solium)","volume":"56","author":"Garcia","year":"2018"},{"key":"b14","series-title":"J Infect Dis","first-page":"50","article-title":"An enzyme-linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium)","volume":"159","author":"Tsang","year":"1989"},{"key":"b15","series-title":"Emerg Infect Dis","first-page":"1340","article-title":"Triplex ELISA for assessing durability of Taenia solium seropositivity after neurocysticercosis cure","volume":"29","author":"Tang","year":"2023"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"1875","article-title":"A Novel, highly sensitive quantitative polymerase chain reaction assay for the diagnosis of subarachnoid and ventricular neurocysticercosis and for assessing responses to treatment","volume":"70","author":"O\u2019Connell","year":"2020"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"1049","article-title":"Reviewing a decade of outpatient tropical medicine in Houston, Texas","volume":"106","author":"Kaplan","year":"2022"},{"key":"b18","series-title":"J Biomed Inform","first-page":"377","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"106","article-title":"Use of statewide hospital discharge data to evaluate the economic burden of neurocysticercosis in Los Angeles County (1991\u20132008)","volume":"83","author":"Croker","year":"2010"},{"key":"b20","series-title":"PLoS Negl Trop Dis","first-page":"e1480","article-title":"The impact of neurocysticercosis in California: A review of hospitalized cases","volume":"6","author":"Croker","year":"2012"},{"key":"b21","series-title":"Medicine (Baltimore)","first-page":"81","article-title":"Neurocysticercosis in Houston, Texas: An update","volume":"90","author":"Serpa","year":"2011"},{"key":"b22","series-title":"PLoS Negl Trop Dis","first-page":"e0010652","article-title":"Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries","volume":"16","author":"Rodr\u00edguez-Rivas","year":"2022"},{"key":"b23","series-title":"Curr Opin Infect Dis","first-page":"339","article-title":"Subarachnoid neurocysticercosis: Emerging concepts and treatment","volume":"33","author":"Nash","year":"2020"},{"key":"b1","series-title":"Clin Microbiol Rev","first-page":"e00085-19","article-title":"Taenia solium cysticercosis and its impact in neurological disease","volume":"33","author":"Garcia","year":"2020"},{"key":"b2","series-title":"Adv Parasitol","first-page":"133","article-title":"Taenia solium taeniasis\/cysticercosis: From parasite biology and immunology to diagnosis and control","volume":"112","author":"Dixon","year":"2021"},{"key":"b3","article-title":"WHO Guidelines on Management of Taenia solium Neurocysticercosis","year":"2021"},{"key":"b4","article-title":"WHO Estimates of the Global Burden of Foodborne Diseases: Foodborne Disease Burden Epidemiology Reference Group 2007\u20132015.","year":"2015"},{"key":"b5","series-title":"Am J Trop Med Hyg","first-page":"354","article-title":"Cysticercosis-related hospitalizations in the United States, 1998\u20132011","volume":"92","author":"O\u2019Keefe","year":"2015"},{"key":"b6","series-title":"Emerg Infect Dis","first-page":"2168","article-title":"Evaluating healthcare claims for neurocysticercosis by using all-payer all-claims data, Oregon, 2010\u20132013","volume":"22","author":"Flecker","year":"2016"},{"key":"b7","series-title":"Microorganisms","first-page":"1221","article-title":"A large case series of neurocysticercosis in Kuwait, a nonendemic Arabian Gulf country in the Middle East region","volume":"9","author":"Iqbal","year":"2021"},{"key":"b8","series-title":"Emerg Infect Dis","first-page":"1","article-title":"Public health implications of cysticercosis acquired in the United States","volume":"17","author":"Sorvillo","year":"2011"},{"key":"b9","series-title":"Emerg Infect Dis","first-page":"969","article-title":"Hospitalization frequency and charges for neurocysticercosis, United States, 2003\u20132012","volume":"21","author":"O\u2019Neal","year":"2015"},{"key":"b10","series-title":"Open Forum Infect Dis","first-page":"ofae176","article-title":"Subarachnoid neurocysticercosis case series reveals a significant delay in diagnosis-requiring a high index of suspicion among those at risk","volume":"11","author":"Beatty","year":"2024"},{"key":"b11","series-title":"Am J Trop Med Hyg","first-page":"945","article-title":"Diagnosis and treatment of neurocysticercosis: 2017 Clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH)","volume":"98","author":"White","year":"2018"},{"key":"b12","series-title":"J Neurol Sci","first-page":"202","article-title":"Revised diagnostic criteria for neurocysticercosis","volume":"372","author":"Del Brutto","year":"2017"},{"key":"b13","series-title":"J Clin Microbiol","first-page":"e00424-18","article-title":"Laboratory diagnosis of neurocysticercosis (Taenia solium)","volume":"56","author":"Garcia","year":"2018"},{"key":"b14","series-title":"J Infect Dis","first-page":"50","article-title":"An enzyme-linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium)","volume":"159","author":"Tsang","year":"1989"},{"key":"b15","series-title":"Emerg Infect Dis","first-page":"1340","article-title":"Triplex ELISA for assessing durability of Taenia solium seropositivity after neurocysticercosis cure","volume":"29","author":"Tang","year":"2023"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"1875","article-title":"A Novel, highly sensitive quantitative polymerase chain reaction assay for the diagnosis of subarachnoid and ventricular neurocysticercosis and for assessing responses to treatment","volume":"70","author":"O\u2019Connell","year":"2020"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"1049","article-title":"Reviewing a decade of outpatient tropical medicine in Houston, Texas","volume":"106","author":"Kaplan","year":"2022"},{"key":"b18","series-title":"J Biomed Inform","first-page":"377","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"106","article-title":"Use of statewide hospital discharge data to evaluate the economic burden of neurocysticercosis in Los Angeles County (1991\u20132008)","volume":"83","author":"Croker","year":"2010"},{"key":"b20","series-title":"PLoS Negl Trop Dis","first-page":"e1480","article-title":"The impact of neurocysticercosis in California: A review of hospitalized cases","volume":"6","author":"Croker","year":"2012"},{"key":"b21","series-title":"Medicine (Baltimore)","first-page":"81","article-title":"Neurocysticercosis in Houston, Texas: An update","volume":"90","author":"Serpa","year":"2011"},{"key":"b22","series-title":"PLoS Negl Trop Dis","first-page":"e0010652","article-title":"Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries","volume":"16","author":"Rodr\u00edguez-Rivas","year":"2022"},{"key":"b23","series-title":"Curr Opin Infect Dis","first-page":"339","article-title":"Subarachnoid neurocysticercosis: Emerging concepts and treatment","volume":"33","author":"Nash","year":"2020"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/6\/article-p1165.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/6\/article-p1165.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/6\/article-p1165.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:16:12Z","timestamp":1780496172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/6\/article-p1165.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":46,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0304","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]}}}