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Parasitology-Lec 8 Taenia

Parasitology-Lec 8 Taenia

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PARASITOLOGY LECTURE 7 \u2013 Taenia + Echinococcus - Dr. Ng
Notes from Lecture
USTMED \u201907 Sec C \u2013 AsM

TAENIA SOLIUM (pork tapeworm)
\u2022
the pork tapeworm producing taeniasis solium or pork
tapeworm infection
DISTRIBUTION
\u2022
Cosmopolitan distribution
o
Countries:
\ue000
Mexico
\ue000
Pakistan
\ue000
Latin America
\ue000
India
\ue000
North China
\ue000
USA (rare)
\ue000
Manchuria
o
Associated with eating raw or insufficient
cooked pork
DISEASES
\u2022
Taeniasis solium - refers to infection of humans with
adult pork tapeworm
\u2022
Human cysticercosis - refers to infection of humans with
larval stage of parasites
\u2022

Diseases produced by infection with larval taenia solium is not uncommon in regions where Taenia solium adult infection exist

\u2022
In human cysticercosis: Man becomes the intermediate
host.
MORPHOLOGY
1. Adult worm
\u2022
Measurement \u2013 2-3 meters
(exceptionally 8 meters in
length)
\u2022
Composition
o
Head
Head or scolex
\ue000
globular in shaped with 4 cup-
shaped suckers
\ue000

provided with conspicuous, rounded rostellum armed with double rows of large and small hooks numbering 22 to 36 and measuring 140 to 200 um and 100 to 150 um in length.

o
Neck (cervical region)
\ue000

short measuring 5 to 10 mm in length (only about one-half as thick as scolex)

o
Proglottids
\ue000
Numbers : 800 to 1,000 proglottids
\ue000
Composed
i. Immature proglottid - broader than
long
ii. Mature proglottid
-
nearly square
-

containing full set of functioning male and female reproductive organs

-
150 to 200 follicles distributed
throughout the dorsal plane
-
uterus \u2013 rises from the anterior
face of ootype
-

trilobed ovary \u2013 situated in the posterior of the proglottid with the presence of accessory ovarian lobe

-
half as many testes asT. saginata
-
Genital pores on consecutive
segments
iii. Gravid proglottid
-
longer than broader
-
consists:
o
common genital pore
with muscular sphincter
o
gravid uterus with 5 to
13
lateral

uterine branches arranged in a Dendritic or finger like fashion

2. Egg
\u2022
Shape \u2013 spherical
\u2022
Color \u2013 pale buff to walnut brown
\u2022
Measurement \u2013 5 to 10 um in
diameter
\u2022
2 radially-striated shells
a. Outer shell \u2013 thin and
rarely seen
b. Inner shell
\u2013
brown, thick and striated
\u2013
embryo or oncosphere with six hooklets
\u2022

Eggs escape from the uterus through the ruptured wall at the anterior end after the ripe proglottids become free

3. Larval stage or bladder worm
\u2022
also
called
Cysticercus
cellulosae
\u2022
measurement \u2013 5 to 10 mm in
length and 5 mm in diameter
\u2022
Consists \u2013 dense milky white spot at one where the
invaginated scolex with hooks and suckers are located
LIFE CYCLE: TAENIA SOLIUM
Life Cycle of Human Cysticercosis
Human Being Harbor Cysticercus Cellulosae:

1. Hetero Infection \u2013 eggs liberated from disintegrating gravid proglottides passed by one individual get into the mouth of another and are swallowed

2. External autoinfection \u2013 eggs maybe transferred from anus to mouth or unclean fingertips of an individual who has an intestinal infection with Taeniasis solium

3.Internal autoinfections \u2013 gravid proglottids in an

individual harboring the adult Taenia solium may become detached from the main strobila or regurgitated into the stomach and then return to duodenal canal where they disintegrate and liberate ripened eggs

PATHOLOGY AND CLINICAL MANIFESTATIONS
1. Pathology brought about by adult taenia solium in lumen
of the small intestines maybe negligible
a. Mild transitory intestinal obstruction
b.Vague abdominal pain similar to hunger pain

which is due to heavy cysticercosis resulting to regurgitation of gravid segments in to the stomach of patients suffering from taeniasis solium

2. pathology brought about by larval stage (cysticercus
cellulosae)
-
serious, because it may lodge in vital organs like
brain, spinal cord, heart, liver and the eyes
-
Symptoms:
a. cellular reactions
b. blood cell infiltration
c. fibrosis
d. necrosis
-
cysticercosis in the brain may cause:
a. epilepsy
b. behavioral changes
c. intermittent obstructive hydrocephalus
d. disequilibrium
e. meningoencephalitis
f.
failing vision
Cross section of
Cysticercosis
Single cysticercus of T. solium
Cysticercus cyst in
of Brain
(left cerebral cortex)
Human muscle
Section of eye with a single Cysticercus of Taenia solium
DIAGNOSIS

1. Demonstration of eggs in stool
a. Direct fecal smear
b. Scotch tape swab

\u2022
Taenia spp. Differentiation is not possible through eggs
examination
2. Demonstration of gravid proglottids in the stool
3. Recovery of scolex after antihelminthic therapy
SPECIES DIFFERENTIATION
T. solium and T. saginata can be made possible thru:
1. scolex:
\u2022
T. solium \u2013 has rostellum armed with spines or hooklets
\u2022
T. saginata \u2013 no well defined rostellum nor spine
2. Segment differentiation
a. Segments:
o
T. solium \u2013 800-1000 segments
o
T. saginata \u2013 1000-2000 segments
b. Lateral branches:
o
T. solium have less than 13 lateral uterine
branches
o
T. saginata have more than 15 lateral uterine
branches
EPIDEMIOLOGY
1. T. solium infection
-
prevalence of infection is directly related to eating
habit of people (raw or insufficient cooked pork)
-
Man is the only known definitive host and the pig

appears to be the only intermediate host
a. Man become the intermediate host
b. Can be caused by:

o
ingestion of eggs from contaminated food or
water
o
contamination from dirty fingers
o

by internal autoinfection when the eggs are carried by reverse peristalsis back to the duodenum or stomach

TREATMENT, PREVENTION AND CONTROL
1. Treatment
a. Praziquantel
-
Dosage: 10 to 20 mg per kg single dose
-
Effect: expel worm in toto
b. Niclosamide
c. Paramomycin
2. Prevention and control
o
Taeniasis solium
-
avoid eating raw or insufficiently cooked
pork
-
proper excreta disposal
o
Human cysticercosis
-
good personal hygiene
-
avoidance
of
drugs
which
causes
disintegration of gravid segments
TAENIA SAGINATA (Adult Beef Tapeworm)
\u2022
infection of man with the adult beef tapeworm
\u2022
Mode of transmission: eating raw or insufficiently
cooked beef containing the cysticercus]
\u2022
Longest human parasite capable of growing to 7.5 m
therefore most individuals harbor only one adult worm
\u2022
cosmopolitan in distribution
o
Africa
o
Mexico
o
Argentina
o
Middle Europe
o
USA
o
Asian-Pacific region
\ue000
Korea
\ue000
Indonesia
\ue000
Philippines
\ue000
Thailand
\u2022

man serve only as definitive host and never as
intermediate host therefore cysticercosis due to Taenia
saginata does not occur

\u2022
It thrives in the upper half of the small intestine
MORPHOLOGY
1. Adult worm
\u2022
Color: Whitish opaque in color
\u2022
Measurement: 5 to 10 meters but may extend up to 25
meters or more
\u2022
Composition
o
Scolex
\ue000

Similar to T. solium except that the rostellum is not well defined and has no spines or hooklets

\ue000
Serve as an organ of attachment in
the mucosa of small intestines
Head or Scolex
o
Neck
o
Proglottids
\ue000
Usual numbers between 1,000 to
2,000 proglottids
\ue000
Extending the small intestine,
sometimes reaching the jejunum
\ue000
Composed:
i. Immature proglottids
ii. Mature proglottids
-
broader than longer
-
contain both male and female
reproductive organ
-
genital organs same with T. solium
-
contains twice as many testes as
T. solium
-
Bilobed ovary with absence of an
accessory ovarian lobe
iii.Gravid or Ripe proglottids
-
narrower and longer
-

uterus containing more than 15 to 20 mm arranged in lateral uterine branches arranged in a tree-like or dichotomose pattern

2. Eggs
\u2022
are indistinguishable between species of T. solium and T.
saginata
\u2022
Shape: rount to slightly oval
\u2022
Measurement: 31 to 43 um
\u2022
Have thick, striated shell and contain the six-hooked
embryo (oncosphere)
\u2022
Can remain viable in soil for days to weeks
\u2022
Eggs of T. saginata by man do not result in infection
3. Larva (cysticercus bovis)
\u2022

Hexacant (six-hooked) larva hatched from egg, actively penetrates the small intestine and migrates by hematogenous route to all organ system

\u2022
Mostly they lodge in the skeletal muscles, where they
encyst in the fascial tissues and develop into
cysticercus, the stage infective to man

Disadvantage \u2013 causes the proglottids
to rupture and releases innumerable
eggs into the bowel lumen and
increase risk of cysticercosis

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