A 6-yr-old female red ruffed lemur (Varecia variegata rubra) with a 48-hr history of lethargy and
anorexia was presented for evaluation of a large cervical mass. A soft fluctuant subcutaneous swelling extending from the dorsal
aspect of the skull to the ventral cervical region was present at physical examination. CBC and serum biochemistries were
unremarkable at the initial examination. Radiographs of the cervical region showed the mass containing discrete areas of
mineralization. Ultrasonography of the mass was non-diagnostic. Surgical exploration of the area revealed a multiloculated mass
with each individual cyst-like structure containing hundreds of bead-like nodules (< 1mm). A wet-prep evaluation of the nodules
determined that they were cestode larvae. Histopathology of a single mass was described as granulomatous cellulitis with
intralesional larval cestodes, a cysticercus. The cestode larvae were identified as Taenia crassiceps. Treatment was
initiated with praziquantel (Droncit, Bayer, Shawnee Mission, KS 66201 USA) at 23 mg p.o. q 10 days for three treatments and
amoxicillin (Trimox, Bristol-Myers-Squibb, Princeton, NJ 08540 USA) at 95 mg p.o. b.i.d. for 10 days. Albendazole (Valbazen,
Pfizer, Exton, PA 08540 USA) at 28.5 mg p.o. b.i.d. was administered for three 10-day treatments with 10-day intervals between each
Weekly examinations were performed for 2 mo to evaluate response to treatment and to monitor for
albendazole-related leucopenia. A 75% reduction in mass size was evident 2 wk after initiation of treatment. Eosinophilia was at
this time (1800/µl) and persisted at day 21 (2541/µl). All subsequent CBC and serum biochemistries were unremarkable. At
1 mo post examination the cervical mass was greatly reduced with only minor thickening of the ventral cervical region present.
Subsequent examinations at 5 and 7 mo were similar. No further symptoms of the disease have been observed for over 1 yr.
The definitive hosts of Taenia crassiceps are wild, northern hemisphere canids including the grey fox
(Urocyon cinereoargenteus) and coyote (Canis latrans). Many wild rodent species serve as intermediate hosts.
Cysticercus formation typically occurs in rodents after ingestion of a Taeniid egg. The cestode infestation in this case most
likely occurred after ingestion of grey fox feces by the lemur. The enclosure in which this lemur was housed would not allow entry
of any animals but it is possible that a fox could have defecated close enough to the enclosure so that the lemur could reach the
Cysticercosis has been reported in other non-rodent species, most recently in immunocompromised domestic
dogs1,4 and humans.3 Cestode infection in lemurs has been primarily reported as a necropsy finding. Hydatid
disease due to Echinococcus granulosus was described in ring-tailed lemurs (Lemur catta).5 Severe invasive
cysticercosis due to Taenia crassiceps infestation was identified at necropsy in a black lemur (Eulemur macaco
macaco).2 Multiple cysticerci were present within the pleural and peritoneal cavities of this individual. Another
report describes the successful surgical excision of a single cysticercus from the thoracic cavity of a red ruffed
lemur.6 No other treatment was necessary for resolution of the problem and recurrence of the disease was not observed.
Species identification of the parasite was not possible.
The cestode infection reported in this particular case was resolved with medical therapy only. Surgical
excision of the mass was not possible due to the extensive nature of the cervical mass. Cysticercosis should be considered as a
differential diagnosis when evaluating lemurs with subcutaneous swellings. Appropriate hygienic and protective precautions must be
taken when managing cases involving Taenia crassiceps due to the potential for zoonotic infection.
1. Chermette R, J Bussieras, M Mialot, PC Raynal. 1993. Subcutaneous Taenia crassiceps
cysticercosis in a dog. J. Am. Vet. Med. Assoc. 203: 253-255.
2. Dyer NW, JH Greve. 1998. Severe Cysticercus longicollis in a black lemur (Eulemur macaco
macaco). J. Vet. Diagn. Invest. 10: 362-364.
3. Francois A, L. Favennec, C Cambon-Michout, I Guiet, N Biga, FB Tron. 1998. Taenia
crassiceps invasive cysticercosis:a new human pathogen in acquired immunodeficiency syndrome? Am. J. Surg. Pathol. 22:
4. Hoberg EP, W Ebinger, JA Render.1999. Fatal cysticercosis by Taenia crassiceps in a
presumed immunocompromised canine host. J. Parasitol. 85: 1174-1178.
5. Shahar R, IH Horowitz, I Aizenberg, 1995. Disseminated hydatidosis in ring-tailed lemur (Lemur
catta): a case report. J. Zoo Wildl. Med. 26: 119-122.
6. Wolff M, M Bush, R Montali, CH Gardiner. 1989. Cysticercus pneumonitis and pleuritis in a
red-ruffed lemur. J. Zoo Wildl. Med. 20: 383-385.