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CESTODES

CESTODES
 Tape worms
 Flat and ribbon like, segmented
 Head or scolex of the worm has 4
muscular cup-shaped suckers for
attachment, hooklets
 Individual Segments are proglottids and
chain of proglottids are strobila
 Hermaphroditic
 Eggs are non operculated
and has 6
hooked embryo- hexacanth embryo
(exception-Diphyllobothrium latum)
TYPES
 Taenia solium
 Taenia saginata
 Diphyllobothrium latum
 Echinococcus granulosus
 Echinococcus multilocularis
 Hymenolepis nana
 Hymenolepis diminuta
 Dipylidium caninum
TAENIA SOLIUM
 Pork(pig) tape worm/cysticercosis
 Reservoir for larvae-hogs, humans
 Reservoir for adults-humans
Life cycle of taenia
 Infective stage - cysticerci (bladder worm) in the
muscle of pigs
 Reaches the small intestine of
humans,attaches.
 Worm produces proglottids,which when mature
contain eggs
 And leave the host in feces->pigs
 In pigs intestine->6 hooked larval form-
>oncosphere->cysticerci
Clinical features
 Adults
 Abdominal discomfort,c/c indigestion,diarrhoea
 Cysticercus (larval stage)
 Cysticerci in the brain causes-meningitis,
hydrocephalus, cranial nerve damage, seizures
 In the eye-visual field defects
Lab diagnosis
 Stool examination-eggs
and proglottids
 Eggs-spherical,possess a
thick radially striated shell
containing a 6 hooked
embryo
 Proglottids of T.solium
are smaller than saginata
and contain only 7-13
uterine branches versus
15-30 for beef tapeworm
 Presence of cysticerci-soft tissue
xrays,visualisation in the eye
 CT,radio isotope scanning or
ultrasonography detects CNS lesions
Treatment and prevention
 DOC-niclosamide
 Avoid consumption of undercooked pork
 In cysticercosis- DOC-praziquantel or
albendazole
 Surgical removal of the cysts may be
required
TAENIA SAGINATA
 Beef tapeworm
 Reservoir-cattle,humans
 Does not produce human cysticercosis
 Clinical features similar to intestinal
infection with T.solium.ie,generally
asymptomatic,but has vague abdominal
pains,c/c indigestion
 Diagnosis – eggs and proglottids;the
adult worm has scolex which lacks the
hooklets
 DOC-niclosamide
 Properly cooked beef
DIPHYLLOBOTHRIUM LATUM
 Fish tapeworm
 One of the largest tapeworms
 Reservoir for larvae-fresh water
crustaceans and fish
 Reservoir for adults-
humans,dogs,cats,bears
 Scolex-has long lateral grooves(bothria)-
for attachment
 Proglottids-broad,has a central uterine
structure,produces eggs with an
operculum (ROSE APPEARANCE)
 Larval form- sparganum /plerocercoid
larva(in the flesh of fresh water fish)
 Ciliated Free swimming larval form-
coracidium
 Disease occurs on consumption of
inadequately cooked fish
 Seen in regions where raw or pickled
fish is common
Life cycle
Clinical features

 Most are asymptomatic
 Occasionally,epigastric pain,abdominal
cramps,nausea,vomiting and weight loss
 There is vit B 12 deficiency associated
with it-megaloblastic anemia and
neurologic manifestations
Diagnosis
 Stool examination-
o Egg-
bile stained, operculated egg with its knob
at the bottom of the cell.
o proglottids-typical rosette uterine structure
Treatment
 DOC- niclosamide
 Vit.B12 supplementation
 Avoid undercooked fish
 Proper disposal of feces
ECHINOCOCCUS GRANULOSUS
 Or unilocular hydatid cyst disease
 Reservoir for larvae- herbivores (sheep)
and humans
 Reservoir for adults- canines
Life cycle
 Adult tape worms only in canine intestine-
>infective eggs
 Eggs ingested by humans->hatch to form
a 6 hooked larvae-ONCOSPHERE
 It penetrates intestine and enters
circulation to reach various tissues mainly,
liver and lungs forms HYDATID CYST
 This cycle occurs in theherbivores which
when killed by canines, ingest the cysts
and produce adult tape worms, excretes
the egg to continue the cycle
 HYDATID CYST-slow growing,tumor like
space occupying structure,enclosed by a
germinative membrane.it produces brood
capsules on the wall – tape worm head
(protoscolices) develop here
 Daughter cysts also develop in the original
mother cyst
 Accumulate fluid,which Is toxic
 If spilled into body cavity-anaphylactic
shock and death
 Finally the daughter cysts and brood
capsules disintegrate,liberating the
protoscolices—HYDATID SAND
 This type of echinococcus cyst is called
unilocular cyst.
Clinical features
 Pressure effects of the slowly growing cyst
is the 1st symptom
 In liver-pressure on bile ducts and blood
vessels and create pain and biliary rupture
 Lungs-cough,dyspnoea and chest pain
 Also disseminated infection affecting the
bone and brain
Diagnosis

 difficult;mainly based on
clinical,radiological,serological findings
 Surgical removal is the treatment of choice
 If inoperable,-high dose
albendazole,mebendazole,praziquantel
 Proper hygeine
HYMENOLEPIS NANA
 Dwarf tape worm
 No intermediate host,but beetles and mice
may be infected
 In heavy infections,diarrhoea,abdominal
pain,headache
Life cycle
Diagnosis-
demonstration of egg
in stool sample
 Egg of hymenolepis
nana-
Thin shelled with a 6
hooked embryo
Treatment ,prevention
 DOC- praziquantel
 Improved sanitation
DIPYLIDIUM CANINUM
 Primarily a parasite of
dogs and cats
 In children whose
mouths are licked by
pets
 Also called pumpkin
seed tapeworm
 Eggs-colorless ,occur in
packets covered by a
tough clear membrane
 Heavier worm load-abdominal
discomfort,anal pruritis,diarrhoea
 Stool examination- characterstic eggs
 DOC- niclosamide
 Deworming of dogs and cats