|How to cite this article:
Patnayak R, Yootla M, Vijaylaxmi B, Lakshmi AY, Jena A, Reddy MK. Hidden parasite-shadow helps in seeking. Ann Trop Med Public Health 2014;7:189
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Patnayak R, Yootla M, Vijaylaxmi B, Lakshmi AY, Jena A, Reddy MK. Hidden parasite-shadow helps in seeking. Ann Trop Med Public Health [serial online] 2014 [cited 2021 Apr 13];7:189. Available from: https://www.atmph.org/text.asp?2014/7/3/189/149504
We have read the article “Cysticercus cellulosae lies in the eyes of the beholder.” by Kodiatte et al. with interest.  We just wanted to add that imageological findings also may help in certain cases to arrive at a definitive diagnosis. As stated by them, indeed, in most instances, there is no clinical suspicion of cysticercosis. The clinical diagnosis provided range from tuberculous lymphadenitis, reactive lymphadenitis, lipoma, neurofibroma, sialadenitis, and abscess to even secondaries. 
In this context, we would like to share our experience. In a previous study, we had observed that usually a part of the body or scolex of the parasite is aspirated by fine needle aspiration cytology (FNAC).  Hence, FNAC does help in the diagnosis of cysticercosis.
Afterwards, we encountered another case of an 11-year-old female child who presented with left posterior triangle swelling of the neck for 2 months. The FNAC showed chronic inflammatory cells with eosinophils, thereby suggesting parasitic infestation. However, parts of the parasite were not noticed in the FNAC smears. The images (ultrasonography and computed tomography [CT]) also suggested presence of a parasite. Subsequently, the patient underwent excision of the swelling. Histopathological examination revealed the presence of the cysticercosis cellulosae.
Computed tomography and magnetic resonance imaging findings, especially help in the diagnosis of human neuro cysticercosis (NCC).  The characteristic appearance of the scolex within a cyst known as “hole-in-dot” sign is considered pathognomonic for cystic lesions of NCC.  The only drawback is that they are not cost-effective mostly in the setup of developing countries.
Hence, we are of the opinion that if imageological findings are available, they should be taken into consideration in the diagnosis of cysticercosis cellulosae.
The authors wish to thank senior technicians Mrs. Ushanandini and Mr. Ramana for their help.
Kodiatte T, Chinaiah P, Mothakapalli T, Kumar H. Cysticercus cellulosae lies in the eyes of the beholder. Ann Trop Med Public Health 2013;6:201-5.
Patnayak R, Kalyani D, SatishRao I, Prayaga A, Sundaram C, Jena A. Cysticercosis: The hidden parasite with short review of literature. Internet J Infect Dis 2007;6.
Giri S, Parija SC. A review on diagnostic and preventive aspects of cystic echinococcosis and human cysticercosis. Trop Parasitol 2012;2:99-108.
Del Brutto OH, Rajshekhar V, White AC Jr, Tsang VC, Nash TE, Takayanagui OM, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology 2001;57:177-83.
Source of Support: None, Conflict of Interest: None