If a patient is infected with tapeworms and the tapeworms are located in her brain, why...

If a patient is infected with tapeworms and the tapeworms are located in her brain, why does giving them a steroid (prednisone) temporarily make them better but then make it worse?

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Tapeworms infect humans through uncooked food such as pork. The adult will divide and will produce proglottids in small intestine. These proglottids contain ova of the tapeworm are released in the feces and can be ingested by animals. Upon ingestion by animals, they will be converted to cysts in muscles and brain of the infected animals. Ova ingested by humans from infected meat can lead to infection in humans. The tapeworm can also infect the brain in humans and cause massive inflammation in the CNS.

Cysts are present in the brain parenchyma causing obstruction of ventricles of brain and inflammation and also cause seizures. Some cysts can grow abnormally large and infiltrate the spaces in brain and spinal cord, which leads to meningitis. Inflammation in the brain due to cysts is called neurocysticercosis (NCC). Inflammation is a result of degeneration of the tapeworms due to immune attack. This inflammation is mostly due to eosinophil infiltration.

Prednisone is a corticosteroid hormone that is known to decrease inflammation. Corticosteroids reduce inflammation in the brain and are used in NCC. Prednisone is prescribed as treatment of brain inflammation in NCC. Prednisone will decrease the migration of polymorphonuclear leukocytes to the site of infection. It also reverses the permeability in the capillaries, leading to decreased inflammation. Further, prednisone is also known to suppress immune attack. All these effects of prednisone are mediated via glucocorticoid receptors present. The signaling results in reduced production of mediators of inflammation.

Prednisone has a major side effect of affecting the immune system as well. Further, it will also decrease any inflammatory process that occurs in the body. This decreases the ability of the body to fight infection. It also creates side effects such as hyperglycemia, insomnia, and increases appetite> There is increase in hypertension, suppression of adrenal glands and osteoporosis. Thus, initially the infected individual feels better due to decreased inflammation in the brain caused by tapeworm infection. However, with long term treatment, the side effects will increase. Hyperglycemia will cause decreased utilization of the blood sugar, making the person feel fatigued. The other side effects will also add to the general unwell feeling by the person.

Sydney Mullin answered 8 months ago

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