Table 2.

Treatment of Selected Cestode, Trematode, and Protozoan Infections of the CNS

Parasite	Medication	Dosage	Precautions	Potential Side Effects
Trypansomiasis (Chagas’ disease)	Benznidazole; steroids may be helpful	5–7 mg/kg/d in adults and 10 mg/kg/d bidtid for 60 d	Up to 30% of adults experience severe side effects	Peripheral neuropathy; neutropenia, nausea, vomiting, liver failure
Echinococcosis	Albendazole	400 mg bid for 1–6 months, pediatrics 15 mg/kg/d for 1–6 months	Concurrent use of dexamethasone or praziquantel may cause toxicity	Abdominal pain, jaundice, and alopecia
Human African trypanosomiasis	Pentamidine isethionate; steroids only if using melarsorpol as treatment	4 mg/kg/d IM for 10 d	Hypotension, pancreatitis, and cardiac arrhythmias can occur with IV or IM administration	Nausea, leucopenia, and elevated creatinine
Naegleria fowlerii	Amphotericin B	1.5 mg/kg/d IV or intrathecally	Steroids may induce hypokalemia	Seizures, hearing loss, cardiac arrhythmia, rash
Paragonimiasis	Praziquantel	75 mg/kg TID for 3 d	Breast-feeding should be delayed for 3 days posttreatment; seizures can occur if disease burden is high	Nausea, vomiting, abdominal pain, dizziness, headache, rash
Schistosomiasis	Praziquantel; treatment of coexisting infections	60 mg/kg/d bid or tid for 1 d	Breast-feeding should be delayed for 3 days posttreatment	Mild; generally well tolerated
Sparganosis	Praziquantel	Not yet determined	Breast-feeding should be delayed for 3 days post-treatment; seizures can occur if disease burden is high	Nausea, vomiting, abdominal pain, dizziness, headache, rash

For treatment options and further information, please consult The Medical Letter or contact the CDC.