Unlike those of most other species of Taenia, cysticerci of T. solium develop readily in humans. Infection occurs when shelled larvae pass through the stomach and hatch in the intestine. People who are infected by adult worms may contaminate their households or food with eggs they or others accidentally eat. Possibly, a gravid proglottid may migrate from the lower intestine to the stomach or duodenum, or it may be carried there by reverse peristalsis. Subsequent release and hatching of many eggs at the same time results in a massive infection by cysticerci.
Virtually every organ and tissue of the body may harbor cysticerci. Most commonly they are found in the subcutaneous connective tissues. The second most common site is the eye, followed by the brain, muscles,
heart, liver, lungs, and coelom. A fibrous capsule of host origin surrounds the metacestode, except when it develops in the chambers of the eye. The effect of any cysticercus on its host depends on where it is located. In
skeletal muscle, skin, or liver, little noticeable pathogenesis usually results, except in massive infection. Ocular cysticercosis may cause irreparable damage to the retina, iris, or choroid. A developing cysticercus in the retina
may be mistaken for a malignant tumor, resulting in the unnecessary surgical removal of the eye.
Removal of the cysticercus by fairly simple surgery is usually successful.
Cysticerci occur rarely in the spinal cord but commonly in the brain. Symptoms of infection are vague and rarely diagnosed except at autopsy. Pressure necrosis may cause severe central nervous system malfunction,
blindness, paralysis, disequilibrium, obstructive hydrocephalus, or disorientation. Perhaps the most common symptom is epilepsy of sudden onset. When this occurs in an adult with no family or childhood history of epilepsy, cysticercosis should be suspected.
Cysticerci apparently evade a host’s defenses by down-modulating its immune response, but when a cysticercus dies, it elicits a rather severe inflammatory response. Many of them may be rapidly fatal to the host, particularly if the worms are located in the brain.