Cestodes

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Cestodes
Taenia saginata Taenia solium Hymenolepis
nana Echinococcus granulosus
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Teania worm
neck
scolex
Mature segment
Gravid segment

1. Teania saginata
2. Teania solium

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Teania saginata
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Double striated egg shell Hexacanth embryo
More than 12 lateral uterine branch
Taenia saginata (beef tape worm)
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Definitive and reservoir host
Human infected by eating undercooked beef
Intermediate host
Gravid segment rupture and release eggs
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• Maturation time 8-10
• weeks .
• Life span up to 25
• years.
• Scolex evaginate in
• small intestine and
• attach it self to
• mucosa of intestine.

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• Pathology
• Adult may be abdominal pain with some abdominal
  disturbance.

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Taenia solium
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-Scolex with hook -Uterine lateral Branches
less than 12
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Usual Intermediate host liberated embryo,via
bloodstream to tissue especially muscle
Definitive and reservoir hosts
Measly pork
Cysticercus is liberated, scolex evaginates,
attaches itself to mucosa of small intestine.
develops to adult. Maturation time 3months.Life
span up to 25 years.
Development of cysticercus cellulosea-5x8-10mm
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• Pathology
• Adult may be abdominal pain with some abdominal
  disturbance.
• Larvae of T.solium produce cystic nodules
  (cysticercosis) in sub- cutaneous tissue and
  muscles with mild symptoms except when present
  in brain it can cause major central nervous
  system sign.

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• Cysticercosis can occur by autoinfection
• Internalantiprestalsis movement of intestine
  gets its contents back to the stomach
• External ova in stool of infected patient
  contaminate his own food or hands

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Hymenolepis nana
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- Autoinfection - Opportunistic
parasitic infection - I.H D.h
Liberated embryo penetrates villus and becomes
cysticercoid in4 days.Cysticrcercoid re-enter
lumen ,attaches itself to mucosa and develops
into adult worm in 10-12 days
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• - Librated embryo penetrates villus
• and becomes cystocercoid in
• 4 days .
• - cysticercoid re-enters lumen,
• attaches itself to mucosa and develops into
  adult worm in 10-12 days.
•  Diagnosis Eggs in stools

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Treatment Disease Tapeworm
Praziquantel 5-10 mg/Kg single dose Taeniasis Taenia saginata
Praziquanlel 5-10 mg/Km single dose Taeniasis Taenia solium adult
Praziquantel (not for ocular cases) 50 mg/Kg divided into 3doses/day for 14 days to hospitalized patient only, -steroid to reduce reaction in brain cysticerci) Cystisercosis Taenia solium larvae
Praziquantel 15-25mg/kg single dose) Hymenolepiasis Hymenolepis nana
-Surgery (removal of cyst after injection of scolicide) -Albendazole Each cours 10-15 mg/kg/day for 30 days, total of 4 course separated by 15 days breaks. Hydatid disease Echinococcus granulosus
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Echinococus granulosus
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3-8 mm in length 4 segments 1-scolex with 4
sucker and hooks, 2- immature 3- mature 4- gravid
segment. - Definitive host is dog.
- Intermediate host is sheep, cattle ,
camel and human.
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Librated embryo penetrates mucosa carried by
blood streams to various sites
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• adult worms in bowels of definitive
• host.
• (2) eggs passed in feces, ingested by humans or
  intermediate host.
• (3) onchosphere penetrates intestinal wall,
• carried via blood to lodge in organs.
• (4) hyatid cysts develop in liver, lungs,
• brain, heart.
• (5) protoscolices (hydatid sand) ingested
• by definitive host.
• (6) attach to small intestine and grow to
• adult worm.

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• Infection
• Human (I.H.), acceidental ingestion of dog feces
  containing eggs.
• Dogs (D.H.) ingest offal (farm feed of ground
  organs) containing cysts.

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• Clinical feature and pathology
• Depend on site and size
• Can cause obstructions and pressure on vital
  organs.
• Or rupture of cyst with anaphylactic shock.
• Some cyst grow for short time ,die and calcify.
• 66 of cyst found in liver in Rt lobe.
• H.cyst in lung cause pul.symptoms and sputum
  containing blood and hydatid fluid.
• Can be found in bone , brain ,spleen and
  kidneys..

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• diagnosis
• Clinically,
• ultrasound scanning and other imaging techniques
• Laboratory
• Serological detection of antibodies.
• Examination of cyst fluid for brood capsules and
  protoscoleces, after surgical removal of cyst.

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• Serologic Testing
• detect antibody response
• IHA (indirect hemagglutination test)
• ELISA (enzyme-linked emmunosorbent assay)

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• Treatment
• Surgical Removal of Hydatid Cysts
• 90 effective but can be risky depending on
  location, size, and advancement of cyst
• may need chemotherapy to prevent recurrance
• Chemotherapy
• Albendazole is preferred treatment because it
  penetrates into hyatid cysts. 
• Dosage 10mg/kg body weight or 400mg 2x daily
  for 4 weeks, repeat cycles as necessary (up to
  12)
• Mebendazole Dosage 40mg/kg body weight 3x daily
  for 3-6 months

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• PAIR Treatment
• Puncture, aspiration, injection, respiration
• Inject protoscolicidal substances into the cyst

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Treatment Disease Tapeworm
Praziquantel 5-10 mg/Kg single dose Taeniasis Taenia saginata
Praziquanlel 5-10 mg/Km single dose Taeniasis Taenia solium adult
Praziquantel (not for ocular cases) 50 mg/Kg divided into 3doses/day for 14 days to hospitalized patient only, -steroid to reduce reaction in brain cysticerci) Cystisercosis Taenia solium larvae
Praziquantel 15-25mg/kg single dose) Hymenolepiasis Hymenolepis nana
-Surgery (removal of cyst after injection of scolicide) -Albendazole Each cours 10-15 mg/kg/day for 30 days, total of 4 course separated by 15 days breaks. Hydatid disease Echinococcus granulosus
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• What you need to know about a parasite
• Scientific name (and commom name)
• Geographic distribution ( in general terms)
• Life-cycle
• Pathogenesis
• Disease(s) caused
• Diagnosis
• Treatment ( drug of choice) prevention

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Resources on Parasitology Centre for
Disease Control and Prevention (CDC)
http//www.dpd.cdc.gov/DPDx/HTML/Para_Health.ht
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Resources on Parasitology
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