GIT&NUT ‫ئ‬ L3:Para

Cestodes affecting GIT

Cestodes Diphyllobothrium latum Taenia saginata Taenia solium

parasite is very similar to
T. saginata,except some
morphological and
biological aspects.
Disease Diphyllobothriasis; Intestinal taeniasis; 1-Pork tapeworm
fish tape-worm infection; beef tapeworm infection(intestinal
broad tapeworm infection. taeniasis).
infection. 2-Ingestion of T. solium
eggs, causing (
cysticercosis)
Geographical European Baltic Cosmopolitan. Pork raising countries
distribution countries and foci in • Especially in cattle
America and Russia. raising countries
Taenia sagina

Morphology Diphyllobothrium latum adult

Egg. Procercoid. Plerocercoid

Taenia solium

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Morpholo Diphyllobothrium latum Taenia saginata Taenia solium

gy
Adult ♡ 3-10 meters in length have more than 3000 ♡ 4 -6 meters in length ♡ 2-4 meters in length and has 800-1000
proglottids. ♡ has 1000-2000 proglottids (segments). segments. ♡ The scolex is globular, has four
♡ The scolex is small, almond-shaped and has ♡ The scolex has four suckers. cup-shaped suckers and a rostellum with a
two deep grooves (bothria). double crown of hooks.
Egg ♡ egg is 70x45Mm, oval,immature and has ♡ yellowishbrown, 30x40Mm, has thick radially striated shell contains mature hexacanth embryo
operculated thick shell. (onchosphere)
Larvae Procercoid: (first stage larva): This is a solid Cysticercus bovis: the larval stage of Taenia spp, Cysticercus cellulosae
elongated organism about 0.5mm with a bladder like, lined with a germinal layer enclosing a
Spherical caudal end having 6-hooks. cavity containing fluid.
Plerocercoid second stage larva -An invaginated scolex with four suckers.
- solid elongated organism 1-2cm with
invaginated anterior end.
- The body is striated but not segmented
Life cycle Habitat: The ileum and sometimes the jejunum. Habitat: In the upper part of the jejunum. Definitive host: Human.
Definitive host: Man and fish eating animals. Definitive host: Human. Intermediate host: Pigs and man.
Intermediate host: Intermediate host: Cattle. Infective stage: Cysticercus cellulosae & Egg
1) First intermediate host: Cyclops (water flea Infective stage: Cysticercus bovis. Mode of infection:
2) Second intermediate host: Fresh water fish. Egg of Taenia saginata not infective to ma • Ingestion of cysticrcus cellulosae in under
e.g. Salmon. Mode of infection: Eating raw, or imperfectly cooked pork meat causes taeniasis
Infective stage: Plerocercoid larva. cooked beef containing cysticerci bovis. •Ingestion of Taenia solium eggs in cysticercosis
Mode of infection: Ingestion of raw or under - A mature worm develops in 8-10 weeks.
cooked fish. - In human small intestine, the proglottids usually
detach singly, migrate through the anus by their
movements or may be carried out in the stool.

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Pathology Diphyllobothrium latum. Taenia saginata

There is little or even no pathological lesions. Adult Taenia is weakly
• The non-specific symptoms are usually due immunogenic and may only
to: induce a moderate
-the absorption of the toxic secretions and eosinophilia.
products of degenerating proglottids • Minor local inflammation due
- or mucosal irritation caused by the worm. to attachment of the scolex to
• The adult worm absorbs large quantities of the mucosa
vitamin B12 and interferes with ileal B 12
absorption.
• Megaloblastic anemia resembling pernicious
anemia (macrocytic hyperchromic anemia) in
2% of patients .

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Clinical picture
Diphyllobothrium latum Taenia saginata
Hunger pain, -Most infected individuals are asymptomatic.
• epigastric fullness, -Mild gastrointestinal symptoms may develop,
• nausea and vomiting. -including:epigastric pain,
• anorexia, -abdominal discomfort,
• Macrocytic hyperchromic -nausea, vomiting,diarrhea,
anemia with thrombocytopenia -increase or loss of appetite.
and mild leukopenia. -Neurosis, perianal itching due to migrating proglottides.
-Moderate eosinophilia.
SST :epi-abdo(nausea, vomiting,diarrhea) app & neurosis
Clinical picture Of Taenia solium
1-Taeniasis ;as Taenia saginata intestinal infection.
2- Cysticercosis, man may act as: dead-end intermediate host after ingestion of T.Solium eggs
,the clinical differs according to the affected organ, it may lead to :
a. Subcutaneous cysticercosis:
• Small, movable, painless modules that are commonly noticed in the arms or chest.
b. Muscular cysticercosis::
• It appears as dot-shaped or ellipsoidal calcification, it may cause myalgia or Abscess like
picture.
c. Ocular cysticercosis:
• This condition is present in 20% of cases.
• Cysts are found in the vitreous humor, subretinal space, and conjunctiva.
• Presents an as blurred vision or loss of vision, iritis, uveitis, and palpebral Conjunctivitis
• In extreme cases, the infection may cause complete detachment of the retina
d. Neurocysticercosis:
• It is the most common and serious form of cysticercosis Infection in the brain due to
mass effects and inflammation Induced by degeneration of cysticerci and release of
antigens.
• It is observed in 60-90% of infected patients.
• Cysts localized within the brain may range anywhere from 4-20 Mm in length, but most
commonly average between 8-10 mm.
• Seizures and headaches are the most common symptom of Neurocysticercosis and occur
in 70-90% of infected patients.
• Other symptoms of Neurocysticerosis include dizziness,Involuntary Muscle
movement,Intracranial hypertension,Dementia, hydrocephalus(excess fluid around the
brain),Psychiatric disturbances, meningoencephalitis, transient paresis,Behavioral
disorders aphasia, and visual disturbances.

SST:Cysticercosis Organs :Su,Mu,O,Neuro

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How to acquire cysticercosis???

➢Ingestion of food/water contaminated with feces containing These eggs or proglottids of
Taenia solium.
➢External autoinfection: Hand to mouth in person had the Adult taenia solium.
➢Internal autoinfection: regurgitation of eggs or gravid Segments to by reverse peristalsis.
Pathogenesis :
The egg hatch releasing the onchosphere that reach the Circulation and reach various organs
forming cysricercous Cellulose.

Diphyllobothrium latum Taenia saginata

Complications Intestinal obstruction: (due to large
number) or perforation.
-Appendicitis, obstructive jaundice
or pancreatitis due to migrating
segments
Diagnosis 1.History Living in endemic Stool examination for the recovery
area,eating raw fish of Taenia eggs and gravid
2.A pernicious type of anemia is proglottids.
suggestive. - It is important to note that the
3. Finding the operculated eggs or eggs of Taenia spp.are identical.
proglottids in the feces is the sure - To differentiate between species in
diagnosis. the laboratory, a
gravid proglottid or scolex must be
recovered and examined for specific
features of each species.
Prevention 1.Health education about the danger Removal of the sources of infection
of eating raw Or imperfectly cooked by treating infected individuals.
fish. •prevention of contamination of soil
2.Sanitary sewage disposal. with human feces.
3.Avoid the sale of fish from heavily • Inspection of beef for cysticerci
infested lakes bovis.
4.Freezing at –10 C for 24 hours • Thorough cooking of beef by
5. Thorough cooking for at least 10 heating above 57 C
minutes at 50 C • Freezing at –10 C for 5 days,
6.Proper drying and pickling of the • pickling in 25% salt solution for 5
fish will kill the Larvae. days destroy cysticerci.

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Treatment
Diphyllobothrium latum Taenia saginata Taenia solium
Praziquantel or niclosamide. 1.Niclosamide (Yomesan): Niclosamide
This is the drug of choice. •Precautions:
2.Praziquantel (Biltricid) is - a saline purge is given a few
used as alternative drug. hours after treatment to
expel the eggs out rapidly.
to avoid internal auto
infection as niclosamide
cause disintegration of the
gravid segment and releasing
of viable eggs in the intestine.

Quiz
1) Ingestion of undercooked beef steak can cause infection with:
a. Taenia solium.
b. Taenia saginata.
c. Diphylobothrium latum .
d. Hydatid disease.
2) The intermediate host in Taenia solium is
a. Cattle .
b. Dog.
c. Man
d. Frogs
3) Macrocytic hyperchromic anemia with thrombocytopenia and mild Leukopenia
characteristic to
a. Fascioliasis.
b. Taenia saginata
c. Diphylobothrium latumd. Taenia solium.
4) Mode of infection of diphylobothrium latum is Ingestion of raw or Insufficiently cooked
a. Beef.
b. Fish.
a. Vegetables
b. Pork.

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