Closeup of a few of the

proglottIds from the

specImen showIng the
rosetteshaped uterus at
the center of each
proglottId
Scolex of
0. lctm
CD||DN NA|E : 8road fIsh tapeworm
HU|AN'S LAFCEST NTESTNAL TAPEWDF|
0SEASE : 0IphyllobothrIasIs, fIsh tapeworm
InfectIon
NTEF|E0ATE HDSTS :
CDPEPD0S (1
st
H)
FFESH WATEF FSH (2
nd
H)
0EFNT7E HDST :
Humans
8ears
0ogs
Cat
|D0E DF TFANS|SSDN:
ngestIon of fresh water fIsh contaInIng
the secondstage larvae 5lerocercod)
0ACNDSS :
The ovoId, operculated eggs passed In
abundance In the human stool and empty
proglottIds In feces are dIagnostIc.
mmature eggs are passed In feces . Under approprIate condItIons, the eggs
mature (approxImately 18 to 20 days) and yIeld oncospheres whIch develop
Into a coracIdIa . After IngestIon by a suItable freshwater crustacean (the
copepod fIrst IntermedIate host) the coracIdIa develop Into procercoId larvae
. FollowIng IngestIon of the copepod by a suItable second IntermedIate host,
typIcally mInnows and other small freshwater fIsh, the procercoId larvae are
released from the crustacean and mIgrate Into the fIsh flesh where they
develop Into a plerocercoId larvae (sparganum) . The plerocercoId larvae are
the InfectIve stage for humans. 8ecause humans do not generally eat
undercooked mInnows and sImIlar small freshwater fIsh, these do not
represent an Important source of InfectIon. Nevertheless, these small second
IntermedIate hosts can be eaten by larger predator specIes, e.g., trout, perch,
walleyed pIke . n thIs case, the sparganum can mIgrate to the musculature of
the larger predator fIsh and humans can acquIre the dIsease by eatIng these
later IntermedIate Infected host fIsh raw or undercooked . After IngestIon of
the Infected fIsh, the plerocercoId develop Into Immature adults and then Into
mature adult tapeworms whIch wIll resIde In the small IntestIne. The adults
of 0. lctm attach to the IntestInal mucosa by means of the two bIlateral
groves (bothrIa) of theIr scolex . The adults can reach more than 10 m In
length, wIth more than J,000 proglottIds. mmature eggs are dIscharged from
the proglottIds (up to 1,000,000 eggs per day per worm) and are passed In the
feces . Eggs appear In the feces 5 to 6 weeks after InfectIon. n addItIon to
humans, many other mammals can also serve as defInItIve hosts for 0. lctm.
P05llobotrm lctm Is found In
temperate and subarctIc lake regIons In
many areas of the world.
PNorthern Europe, Canada, Alaska, the PacIfIc
Coast of the UnIted States, Japan, TaIwan,
SIberIa, |anchurIa, AustralIa, southern South
AmerIca, and southern AfrIca.
P 20 to J0 feet Is common; shed up to 1 mIllIon eggs a day;
head Is the smallest part of the worm (less than 1mm);
scolex has dorsal and ventral suckers; proglottIds are wIder
than they are long; uterus Is In the center of proglottId
(rosette shaped); eggs are 40 to 60 wIth an operculum;
worms are whIte
P Adults of 05llobotrm spp. may be 410 meters In
length. The scolex Is elongated, 1 mm by J mm, wIth two
shallow, longItudInal grooves. As proglottIds mature, they
may break off from the stroblIa, In lengths contaInIng few
to many segments. ProglottIds are broader than they are
long and range from 2 to 4 mm long by 10 to 12 mm
wIde. The uterus Is coIled In rosette appearance and the
genItal pore Is at the center of the proglottId. There are
numerous testes that appear In the lateral fIelds of each
proglottId.
P0IphyllobothrIasIs can be a longlastIng
InfectIon (decades). |ost InfectIons are
asymptomatIc. |anIfestatIons may Include
abdomInal dIscomfort, dIarrhea, vomItIng,
and weIght loss. 7ItamIn 8
12
defIcIency wIth
pernIcIous anemIa may occur. |assIve
InfectIons may result In IntestInal
obstructIon. |IgratIon of proglottIds can
cause cholecystItIs or cholangItIs.
PabdomInal dIscomfort and dIarrhea; has
affInIty for vItamIn 812 (wIll take most of It
If Infected for a long tIme); pernIcIous
anemIa (red blood cells don't mature and
whIte blood cell productIon drops)
|IcroscopIc IdentIfIcatIon of eggs In the stool
Is the basIs of specIfIc dIagnosIs. Eggs are
usually numerous and can be demonstrated
wIthout concentratIon technIques.ExamInatIon
of proglottIds passed In the stool Is also of
dIagnostIc value.
0IagnostIc fIndIngs
P|Icroscopy
P|orphologIc comparIson wIth other IntestInal
parasItes
PPrazIquantel Is the drug of choIce.
PAlternatIvely, NIclosamIde can also be used
to treat dIphyllobothrIasIs