1 The adult worm lives in the intestine of humans.

2 The larvae ( Cysticercus cellulosae bladder worm) localize in pigs mainly. 3 Cysticercus cellulosae can also infect humans causing cysticercosis.

Morphology
Adult : 2-4 m long, 700-1000 segments: Scolex Neck Immature segment Mature segment Gravid segment

Morphology
Scolex: 1mm in diameter, a rostellum armed with two circles of hooks. ( armed tapeworm) four suckers Neck: The region for proliferation
rostellum sucker

Immature segment
note that the reproductive organs are just beginning to differentiate.
(Carmine stained)

Developing reproductive organs

Mature segments (proglottids)

Hermaphroditic testes, sperm duct ovary, uterus genital pore vitellaria (yolk gland) excretory canal

Mature segment

Gravid segment
Note : Less than 14

lateral uterine branches (one side)

India ink stained

Cysticercus cellulosae

cyst

Scolex

The cyst is filled with fluid

Cysticercus cellulosae
It is soybean-like in shape, has an small scolex invaginated into the translucent cyst. (left) The scolex evaginated from the cyst (right)

Cysticercius cellulosae

Cystcercus cellulosae in muscles of pigs

Taenia saginata (beef tapeworm)

4-8 m ,

1000-2000 segments
Scolex Neck Immature segment

Mature segment
Gravid segment

Scolex and Neck

1.5- 2 mm in

diameter Without rostellum and hooks Four suckers ( unarmed tapeworm)

Mature segment (ovary with 2 lobes)

Note : Bilobed ovary

(Carmine stained)

Gravid segment
India ink technique
Note : More than 15 lateral

uterine branches (one side).

Cysticercius bovis Show invaginated scolex (left) show evaginated sscolex (right) The scolex is similar to that of adult worm in morphology

Cysticercius bovis

Cysticercus bovis
Cysticercus bovis showing the bladder and the scolex (measly beef)

Taenia eggs
The eggs of Taenia saginata and T. solium are indistinguishable morphologically .

Taenia egg

spherical 31 to 43 m a thick embryophore an oncosphere inside an egg shell outside (usually break away from the eggs in the feces)

Gravid segment
( the primary lateral branches of the uterus) Taenia solium The uterus has 7 to 13 lateral branches on each side Taenia saginata The uterus has 15 to 30 lateral branches on each side

Life cycle of Taenia solium

Humans serve as final hosts as well as intermediate hosts in the life cycle of Taenia solium. ( both adult and bladder worm parasite in humans) 1 The adult worm lives in the small intestine of humans ( pork tapeworm infection) 2 The larvae (Cysticercus cellulosea, bladder worm ) localize and develop in pigs (intermediate host) 3 The cysticercus cellulosae may also infect humans causing cystcercosis (humans as intermediate hosts)

Life cycle of Taenia saginata

The life cycle of Taenia saginata is similar to that of Taenia solium, but the intermediate host is cattle. The custicercus bovis (the beef bladder worm ) nearly does not parasite in human body. Humans serve as the final hosts only. (beef worm infection)

 Humans are the only definitive hosts for Taenia

saginata and Taenia solium.

Eggs or gravid proglottids are passed with feces The eggs can survive for days to months in the environment. Cattle (T. saginata) and pigs (T. solium) become

infected by ingesting eggs or gravid proglottids

In the animal's intestine, the oncospheres hatch ,

invade the intestinal wall, and migrate to tissues, where they develop into cysticerci.

 A cysticercus can survive for several years

in the animal. Humans become infected by ingesting raw or undercooked infected meat . In the human intestine, the cysticercus develops over 2 months into an adult tapeworm, which can survive for years. The adult tapeworms attach to the small intestine by their scolex and reside in the small intestine The adults produce gravid proglottids which detach from the tapeworm, and migrate to the anus or are passed in the stool.

Life cycle

Geographic Distribution Both species are worldwide in distribution. Taenia solium is more prevalent in poorer communities where humans live in close contact with pigs and eat undercooked pork, and in very rare in Muslim countries.

Clinical Features
Taenia saginata taeniasis produces mild

abdominal symptoms and may cause malnutrition. (Epigastric pain, vomiting, diarrhea) The most striking feature consists of the passage (active and passive) of proglottids. The patients may find gravid proglottids themselves and take the segments to see doctors. Occasionally, appendicitis or cholangitis can result from migrating proglottids.

Taenia solium taeniasis is less symptomatic than Taenia saginata taeniasis.

The main symptom is often the passage (passive) of proglottids. The most important feature of Taenia solium taeniasis is the risk of development of cysticercosis.

Laboratory Diagnosis
Microscopic identification of eggs and

proglottids in feces is diagnostic for taeniasis.

Repeated examination and concentration

techniques will increase the likelihood of detecting light infections.

Species determination of Taenia is

impossible if solely based on microscopic examination of eggs, because all Taenia species produce eggs that are morphologically identical.

 Eggs of Taenia sp. are also

indistinguishable from those produced by cestodes of the genus Echinococcus.

Microscopic identification of gravid

proglottids (or, more rarely, examination of the scolex) allows species determination.

Summary on differentiations between the two species of tapeworms

Feature Body length No. of segments Scolex T. solium 2-4m 700-1000, thinner, transparent globular (1mm), with a rostellum and hooks trilobed ovary ( a small central lobe) The uterus has 7-13 lateral braches on each side T. saginata 4-8m 1000-2000, thicker, untransparent pyriform (1.5 - 2mm), without rostellum and hooks bilobed ovary 15-30 lateral branches on each side

Mature segment Gravid segment

Diagnostic findings
Microscopy: 1 egg * The eggs can not be

used as species identification.

2 scolex

Differential Morphology of the Diagnostic stages of the two species: gravid segment
Species (Gravid segment) Taenia solium Size Appearance of Uterus Central "stem" with 7-13 main lateral branches on each side. Other

12 mm in length x 5-7 mm wide

Usually on surface of fecal material. May be in short chains of 2-3 proglottids. Usually on surface of fecal material. May be single detached proglottids

Taenia saginata

16-20 mm long Central "stem" with 15-30 5-7 mm wide. main lateral branches on each side.

gravid segment The most important diagnostic stage of the two species taeniasis.

 Antibody detection may prove useful

especially in the early invasive stages, when the eggs and proglottids are not apparent in the stools.

Treatment:

Treatment is simple and very effective. Praziquantel* is the drug

of choice.

Cysticercosis
Causal Agent:

The cestode (tapeworm) Taenia solium (pork tapeworm) is the main cause of human cysticercosis.

Life Cycle

Cysticercosis is an infection of both humans and pigs with the larval stages of Taenia solium. This infection is caused by ingestion of eggs of a human tapeworm carrier. Pigs and humans become infected by ingesting eggs or gravid proglottids Humans are infected either by ingestion of food contaminated with feces, or by autoinfection.

In autoinfection, a human infected with adult T. solium can ingest eggs either through fecal contamination or, possibly, from proglottids carried into the stomach by reverse peristalsis

 Once eggs are ingested, oncospheres

hatch in the intestine , invade the intestinal wall, and migrate to striated muscles, as well as the brain, liver, and other tissues, where they develop into cysticerci.

In humans, cysts can cause serious

results if they localize in the brain, resulting in neurocysticercosis

Clinical Features
The symptoms of cysticercosis are caused by

the development of cysticerci in various sites. Of great comcern is cerebral cysticercosis (or neurocysticercosis), which can cause manifestations including seizuresmental disturbances, focal neurologic deficits, and signs of space-occupying intracerebral lesions. Death can occur suddenly

Cerebral cysticercosis

 Extracerebral cysticercosis can cause

ocular, cardiac, or spinal lesions with associated symptoms Asymptomatic subcutaneous nodules and calcified intramuscular nodules can be encountered.

Cysticercosis

Cysticercus cellulosae

in heart ( Cardiac cysticercosis )

Ocular cysticercosis Patient may complain of blurred vision even blindness. serious symptoms usually occur after the death of the cysticercus

Laboratory Diagnosis
The definitive diagnosis consists of

demonstrating the cysticercus in the tissue involved.

Persons who are found to have eggs or

proglottids in their feces should be evaluated serologically since autoinfection, resulting in cysticercosis, can occur.

Diagnostic findings
Antibody detection provides a useful adjunct

in specific diagnosis Improved imaging techniques such as CT and MR can be very useful in detecting cysticerci in various organs .

Antibody detection:
Sera from patients with cysticercosis react with at least one of the specific proteins (left) whereas sera from patients with echinococcosis do not react with any of the seven diagnostic proteins.(right)

Treatment
Infections are generally treated with antiparasitic drugs in combination with anti-inflammatory drugs . Surgery is sometimes necessary to treat infection in the eyes, cases that are not responsive to drug treatment, or to reduce brain edema . The use of albendazole and praziquantel is controversial .

Summary
Organism Transmissio n Symptoms Diagnosis Treatment

Taenia saginata Taenia solium

Measly beef Epigastric pain, Proglottids or vomiting, eggs in stool or diarrhea perianal area Measly pork Epigastric pain, Proglottids or vomiting, eggs in stool or diarrhea perianal area Muscle pain and weakness, ocular and neural problems CT , MR antibody detection

Praziquantel

Praziquantel

T. solium Cysticercosis

Oral-fecal

Praziquantel or Albendazole