Taenia

There are 2 important human pathogens in the genus Taenia

Humans are the definitive hosts for taenias
Ie adult form exists in humans
The oncosphere invades cattle tissues forming cysticercus
This is a complex cyst
Structure contains the embryonic form of the worm
For the Pig tape worm
Cysticercus stage C! develop in H"#!S producing pathology
#ost pple with $eef tape worms are S%#PT&#TIC
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Important
properties
Scolex
Can be identified by its scolex
This has * suc(ers and a circle of hoo(s
Gravid proglottids
lso can be identified by its gravid proglottids which have +,-. primary uterine branches
This feature is important because cannot distinguish the spp by loo(ing at the eggs/ #"S T loo( at uterus
Eggs
0ggs appear the same microscopically as those of T. saginata and Echinococcus spp
Scolex
Has a scolex with four suc(ers $"T !&
H&&120TS
Gravid proglottids
-+,2+ prmary uterine branches in contrast to T/
solium proglottids which have +,-.
HS #&30 2T032 $3!CH0S
This feature is important because cannot distinguish
the spp by loo(ing at the eggs/ #"S T loo( at
uterus
Eggs
0ggs are morphologically indistinguishable from
T/solium
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm)
4isease The adult form of Taenia solium causes taeniasis The larval form of Taenia solium causes
cysticercosis
Cause taeniasis
The larvae do !&T cause cysticercosis
In taeniasis5 the adult tape worm is located in the
human intestine
In cysticercosis5 a more dangerous se6uence
occurs
P03S&! I!70STS 8&3# 077S in food or water
that has been C&!T#I!T04 with H"#!
F0C0S
In taeniasis5 the adult tape worm is located in the
human intestine
0pidemiology The epidemiology of taeniasis is related to
ccess of pigs to human feces
nd to the consumption of raw or undercoo(ed por(
4isease occurs worldwide but is endemic in some
areas of sia5 South merica and 0astern 0urope
9 0pidemiology of cysticercosis is related to
contamination of food or water with human feces
In addition to the access of pigs to human feces
and to the consumption of raw or undercoo(ed por(
0pidemiology is related to
ccess of cattle to human feces
nd consumption of raw or undercoo(ed beef
4isease occurs worldwide $"T is endemic in frica5
South merica and 0astern 0urope
3oute of
infection
In taeniasis5 the adult tape worm is located in the
human intestine
This occurs when humans are infected by eating
raw or undercoo(ed por( containing the larvae or
cysticerci
cystircercus consists of a pea si:ed5 fluid filled
bladder with an invaginated scloex
From NOTES
T/ solium also infect man as the larval stage
Route of infection:
• $y ingesting eggs
Contamination of food by fecal matter from
someone with pig tape worm
H0!C0 can get cysticercosis 0;0! if you
4&!<T eat por(
• &r possibly by =Internal autoinfection>
This route is less clear/ Suspect that a segment
of the worm gets bac( into the stomach from
the intestines and dissolves/ 0ggs are released
and this appears to mimic the swallowing of
eggs/
P03S&! I!70STS 8&3# 077S in food or water
that has been C&!T#I!T04 with H"#!
F0C0S Note that in cysticercosis, humans are
infected y eggs excreted in human feces, not
y ingesting undercoo!ed por!"
!ote also the PI7S 4& !&T H;0 TH0 4"2T
worm in their intestines so they are !&T the source
Humans are infected by eating raw or undercoo(ed
$00F containing larvae Cysticerci
of eggs that cause human cysticercosis
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm)
2ife cycle #out the hosts
Humans are the definitive hosts
Pigs are the intermediate hosts
#out the life cycle
In the small intestine5 the larvae attach to the gut
wall and ta(e about ? months to grow into adult
worms measuring up to +m
The gravid terminal proglottids containing many
eggs detach daily and are passed in feces and are
accidentally eaten by pigs
!ote that pigs are infected by the worm eggs
TH030F&305 it is the larvae 'cysticerci) that are
found in the pigs
@ hoo(ed embryo 'oncosphere) emerges from
each egg in the pig intestine
The embryos burrow into the wall into a blood
vessel and are carried to s(eletal muscle
They develop into cysticerci in the muscle5 where
they 30#I! till eventually eaten by a H"#!
9 Cant really complete the cycle5 unless someone
happens to ingest the cysticerci in human fleshA
#out the hosts
Humans are the definitive hosts
Cattle are intermediate hosts
#out the life cycle
In the small intestines5 the larvae attach to the gut
wall and ta(e about ? months to grow to adult
worms measuring about -.m
The gravid proglottids detach and are passed in
feces and eaten by cattle
The embryos oncospheres emerge from the eggs in
the C&8s intestines and burrow into a blood vessel
where they are carried to s(eletal muscle
In s(eletal muscle5 they develop into cysticerci
The cycle is completed when cysticerci are
I!70ST04
Pathogenesis dult tapeworm attached to the intestinal wall
causes 2ITT20 damage
The 077S hatch in the small intestine
The oncospheres burrow through the wall into a
blood vessel
They can then disseminate to many organs
0SP0CI22% TH0 0%0S !4 TH0 $3I! where
they encyst to form cysticerci
Cysticerci can become very 2370 esp in the
$3I! where they manifest as a space occupying
lesion
2iving cysticerci do not cause inflammation5 $"T
when they 4I05 they release substances that
provo(e an inflammatory response
0ventually5 the cysticerci calcify
2ittle damage results from the presence of adult
worm in the small intestine
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm)
Clinical findings #ost pple with adult tape worms are asymptomatic
These symptoms can occur
norexia
4iarrhea
Some may notice proglottids in the stools
From NOTES
Cysticerci '=bladder worms>) found in tissues
including brainB may cause epilepsy5 encephalitis5
hydrocephalus
8&3ST infection is in the brain
Cysticercosis in the brain causes
Headache
;omiting
Sei:ures
Cysticercosis in the eyes
ppears as uveitis or retinitis
Subcutaneous nodules containing cysticerci
commonly occur
#ost pple with a adult tape worms are
asymptomatic
$"T malaise and mild cramps can occur
Proglottids may appear in the stools
#ay even protrude from the anus
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm)
4iagnosis From NOTES
Proglottids may be noticed in faecesB
Can differentiate T/ solium from T/ saginata
SH&"24 2&&1 T& P3&72&TTI4S T&
4IFF03!TIT0 TH0 SPP
0ggs seen in faeces 'H&80;03 TH0S0 30
I40!TIC2)
Identification of T. solium consists of finding gravid
proglottids with +,-. primary uterine branches in the
stools
0ggs are found in the stools 20SS often than the
proglottids
From NOTES
Serology
CT5 #3I scans
Calcified lesions in muscles
Can see calcified lines5 which represent the dead
calcified cysticerci
#3I is good at resolving detail/
#ay even see embryo in the cysts
4iagnosis of cysticercosis depends on
demonstrating the presence of the cyst in tissue5
usually by surgical removal or CT scan
Serologic tests that detect antibodies to T/ solium
antigens are available5 $"T #% $0 !07TI;0 I!
In contrast to T.solium5 T.saginata proglottids have
-+,2. primary uterine branches
0ggs are found in the stools 20SS often than the
proglottids
!0"3&C%STIC03C&SIS
Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm)
Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm)
Treatment From NOTES
Intestinal Taenia tapewormB niclosamide
T/ soliumB some physicians would give an
antiemetic an hour before starting treatment
This is to prevent irritation in the intestinal tract from
treatment from producing reverse peristalsis which
can lead to segments of the worm ending up in the
stomach thus creating ris( of patient developing
cysticercosis/
Pra:i6uantel also effective
From $evinsons
Intestinal worms tx of choice is pra:i6uantel
F3&# !&T0S
Cerebral 'neuro,) cysticercosisB
0CP03T &PI!I&! !00404
70!0322% use antihelminth drugs with
anitinflammatory drugs
Consider alenda%ole or pra%i&uantel5 under
supervision
!&T0 that !&T every patient re6uires antihelminth
treatment/ !eed expert opinion/ Chec( with
neurologist/
Steroids D treatment leads to inflammation around
damaged cysts 'C!S symptoms may worsen due to
inflammation produced after the cyst is (illed hence
need to use anti,inflammatory drugs/)
#nti'epilepsy medication as necessary 'eg if the
patient presents with epilepsy)
From $evinsons
Tx for cysticercosis is also pra:i6uantel $"T
surgical excision may also be necessary
lbenda:ole is an alternative to pra:i6uantel
Intestinal worms tx of choice is pra:i6uantel
Prevention Prevention of taeniasis involves
• Coo(ing por( ade6uately
• 4isposing of waste properly so that pigs
C!!&T ingest human feces
Prevention of cysticercosis consists of
• Tx of patients to P30;0!T "T&I!F0CTI&!
• &bservation of proper hygiene including hand
washing to prevent contamination of food with
the eggs
Prevention of taeniasis involves
• Coo(ing beef ade6uately
• 4isposing of waste properly so that cattle
C!!&T ingest human feces