CESTODES

INTESTINAL CESTODES
SCIENTIFIC NAME COMMON NAME
Diphyllobothrium latum Fish tapeworm or broad tapeworm
Taenia saginata Beef tapeworm
Taenia solium Pork tapeworm
Hymenolepis nana Dwarf tapeworm
Hymenolepis diminuta Rat tapeworm
Dipyllidium caninum Dog tapeworm
Raillietina garrisoni
EXTRAINTESTINAL CESTODES
Echinococcus granulosus Hydatid worm
Spirometra spp.

INTESTINAL CESTODES
Cestode Diagnostic Stage
Unembryonated eggs or
Diphyllobothrium latum
scolex in feces
Taenia saginata
Eggs or proglottids in feces
Taenia solium
Hymenolepis nana
Unembryonated eggs in
feces
Hymenolepis diminuta
Gravid proglottids release
Dipylidium caninum
egg packets in feces
Gravid proglottids with
Raillietina garrisoni
egg capsules in feces
EXTRAINTESTINAL CESTODES
Hydatid cyst in various
Echinococcus granulosus
organs
Unembryonated eggs in
Spirometra spp.
feces
Infective Stage
Plerocercoid larva
Cysticercus bovis
Cysticercus cellulosae
Cysticercoid larva
Fully embryonated eggs in
feces
Plerocercoid larva
Mode of Transmission
Ingestion of infected fish
Ingestion of raw infected
beef
Ingestion of raw infected
pork
Ingestion of embryonated
egg or cysticercoid larva
Ingestion of infected rat
flea or flour beetle
Ingestion of infected dog
flea
Ingestion of infected flour
beetle
Ingestion of fully
embryonated eggs
Ingestion of plerocercoid
larva

INTESTINAL CESTODES
Cestode Pathognomonic Treatment
Hyperchromic, megaloblastic
Diphyllobothrium latum anemia with thrombocytopenia and
leukopenia; Vit. B12 deficiency
Praziquantel
Obstruction of bile, pancreatic ducts,
Taenia saginata and appendix; passage of proglottids
in stool
Cycticercosis
Serious: Neurocysticercosis (NCC)
Taenia solium Praziquantel and Niclosamide
> Racemose cysticercosis:
aggressive NCC
Enteritis due to necrosis and
Hymenolepis nana desquamation of intestinal epithelial
cells Praziquantel
Hymenolepis diminuta Lifespan is short
Dipylidium caninum Symptoms are minimal
EXTRAINTESTINAL CESTODES
Surgical resection; PAIR
(Percutaneous, Aspiration, Injection,
Echinococcus granulosus Cystic echinococcosis
Re-aspiration) Mebendazole or
Albendazole
Surgical removal of larvae from
Spirometra spp. Migrating tumor
infected tissue
 Tapeworms Characteristic Eggs
Diphyllobothrium latum Operculated & unembryonated
Taenia saginata
Spherical & striated; embryonated
Taenia solium
Hymenolepis nana Spherical, colorless or clay-colored
Circular and bile-stained; sunny side/fried
Hymenolepis diminuta
egg appearance
Spherical, thin-shelled with hexacanth
Dipylidium caninum
embryo; enclosed in an egg capsule
Enclosed in an egg capsule with 1-4
Raillietina garrisoni
spindle-shaped eggs
Echinococcus granulosus Embryonated like Taenia spp. eggs
Spirometra spp. Operculated & immature

Tapeworms Intermediate Host

Diphyllobothrium latum 1st: Copepod, 2nd: Freshwater fish
Taenia saginata Cattle
Taenia solium Pigs (Man)
Hymenolepis nana NONE
Hymenolepis diminuta Rat flea
Dipylidium caninum Dog flea
Raillietina garrisoni Flour beetle
Echinococcus granulosus Sheep (Man)
Spirometra spp. Humans
TREMATODES
BLOOD FLUKES
SCIENTIFIC NAME COMMON NAME
Schistosoma japonicum Oriental blood fluke
Schistosoma mansoni Manson’s blood fluke
Schistosoma haematobium Vesical blood fluke
LUNG FLUKES
Paragonimus westermani Oriental lung fluke
INTESTINAL FLUKES
Fasciolopsis buski Giant intestinal fluke
Echinostoma ilocanum & Artyfechinostomum
Heterophyid fluke
malayum
Heterophyes heterophyes Von Siebold’s fluke; Heterophyids
LIVER FLUKES
Fasciola hepatica Sheep liver fluke, Temperate liver fluke
Fasciola gigantica Giant liver fluke, Tropical liver fluke
Chlonorchis sinensis Chinese liver fluke, Oriental liver fluke
Opisthorchis felineus Cat liver fluke, Siberia liver fluke

Fluke
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium
Paragonimus westermani
Fasciolopsis buski
Echinostoma ilocanum &
Artyfechinostomum malayum
Heterophyes heterophyes
Fasciola hepatica
Fasciola gigantica
Chlonorchis sinensis
Opithorchis felineus
BLOOD FLUKES
Diagnostic Stage
Eggs in feces
Eggs in feces
Eggs in urine
LUNG FLUKES
Unembryonated eggs in feces
INTESTINAL FLUKES
Unembryonated eggs in feces
Unembryonated eggs in feces
Embryonated eggs with fully-
developed miracidium in feces
LIVER FLUKES
Unembryonated eggs in feces
Unembryonated eggs in feces
Embryonated eggs in feces
Embryonated eggs in feces
Infective Stage Mode of Transmission
Cercariae Skin penetration
Ingestion of 2nd Int. host
Metacercariae
(crab or crayfish)
Ingestion of 2nd Int. host
(plants/vegetation)
Ingestion of 2nd Int. host
Metacercariae
(snails)
Ingestion of 2nd Int. host
(fish)
Ingestion of 2nd Int. host
(plants/vegetation)
Ingestion of 2nd Int. host
(plants/vegetation)
Metacercariae
Ingestion of 2nd Int. host
(fish)
Ingestion of 2nd Int. host
(fish)

MATURE EGGS: COSH (Chlonorchis, Opisthorchis, Schistosoma, Heterophyids)

IMMATURE EGGS: PEFF (Paragonimus, Echinostoma, Fasciola, Fasciolopsis)

Flukes Characteristic Eggs

BLOOD FLUKES
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium
LUNG FLUKES
Paragonimus westermani
INTESTINAL FLUKES
Fasciolopsis buski
Echinostoma ilocanum &
Artyfechinostomum malayum
Heterophyes heterophyes
LIVER FLUKES
Fasciola hepatica
Fasciola gigantica
Chlonorchis sinensis
Opisthorchis felineus
Unoperculated & embryonated; ovoid/pear-shaped, pale
yellow; with small rudimentary knob
Unoperculated & embryonated; with prominent lateral spine
Unoperculated & embryonated; with prominent terminal
spine
Operculated & immature with shoulders; yellowish-brown
Operculated & immature; indistinguishable from Fasciola spp.
Operculated & immature; germ ball egg
Operculated & mature; ovoid, light-brown
Operculated & immature; large, ovoidal, yellowish-brownish
Operculated & immature
Operculated & mature; ovoid, yellowish-brown
Operculated & mature
 Flukes
BLOOD FLUKES
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium
LUNG FLUKES
Paragonimus westermani
INTESTINAL FLUKES
Fasciolopsis buski
Echinostoma ilocanum &
Artyfechinostomum malayum
Heterophyes heterophyes
LIVER FLUKES
Fasciola hepatica
Fasciola gigantica
Chlonorchis sinensis
Opisthorchis felineus
Definitive Host Intermediate Host/s
Snail (Oncomelania hupensis quadrasi)
Man Snail (Biomphalaria spp.)
Snail (Bulinus spp.)
1st: Snail (Antemelania asperata),
Man 2nd: Crab or crayfish (Mountain crab:
Sundathelphusa philippina)
Pigs 1st: Snail, 2nd: Plant/vegetation
Man 1st: Snail, 2nd: Snail
Man 1st: Snail, 2nd: Fish
Sheep 1st: Snail, 2nd: Plant/vegetation
Cow 1st: Snail, 2nd: Plant/vegetation
Man 1st: Snail, 2nd: Fish
Cat 1st: Snail, 2nd: Fish

Flukes Pathognomonic Treatment

BLOOD FLUKES
Schistosoma japonicum
Scistosoma mansoni
Scistosoma haematobium
LUNG FLUKES
Paragonimus westermani
INTESTINAL FLUKES
Fasciolopsis buski
Echinostoma ilocanum &
Artyfechinostomum malayum
Heterophyes heterophyes
LIVER FLUKES
Fasciola hepatica
Fasciola gigantica
Chlonorchis sinensis
Opisthorchis felineus
“Swimmer’s itch” and Katayama fever
Intestinal Bilharziasis
Praziquantel
Bilharziasis; Urinary schistosomiasis;
Bladder cancer
Endemic hemoptysis; Paragonimiasis Praziquantel
Traumatic, obstructive, toxic; Inflammation
and ulceration at attachment site
Inflammation at attachment site; ulceration
Praziquantel
and diarrhea (blood)
Peptic Ulcer Disease (PUD) & Acid Peptic
Disease (APD)
Acute Phase: high fever, hepatomegaly,
marked eosinophilia
Triclabendazole (Alt.:
Chronic Phase: Fibrosis; obstructive
Bithionol)
jaundice, haemobilia, biliary cirrhosis
Cholangiocarcinoma; desquamation of
epithelial cells, hyperplasia; Bile duct cancer Praziquantel