Two unusual cases of cysticercosis in children, ages 6 and 3 years, without risk factors or infected contacts, and five additional cases in children <2 years, are reported from Loyola University Chicago Stritch School of Medicine, Maywood, IL; University of Illinois at Chicago Medical Center; Children’s Memorial Hospital, Chicago; and Centers for Disease Control and Prevention, Atlanta, GA. The source of infection was not identified in cases 1 and 2, and pork was never or only occasionally consumed. Both children were born and lived in Chicago. One had travelled to Ireland twice, where cysticercosis is not endemic. Cases 3 to 7 were born in the US, but had parents and other relatives from Latin America. Five patients had focal seizures and two had generalized seizures, as the presenting symptoms in 6 cases. One child presented with an inflamed, cystic, subcutaneous swelling on his back. An initial CT was negative, but a ring-enhancing lesion in the temporal lobe was found after seizures developed and before antiparasitic therapy was instituted. All other cases had positive CTs on admission. After treatment with dexamethasone for 3 days and praziquantel for 15 days, seizures did not recur. [1]

COMMENT. Neurocysticercosis in the US is rare, especially in children, but an increased incidence in the last decade is reported, even in patients who have never travelled to endemic areas. Taenia solium eggs may survive under finger nails, on skin, clothes, as well as fecal-oral spread. In patients without known contacts, restaurant food handlers from endemic areas are suspected as a source of infection. Neurocysticercosis and serological testing must be added to the differential diagnosis of a seizure disorder in children.