Cestodes

Supachai A. Basit, RMT, M.Bio.Ed.

S.A. Basit

Classification of Cestodes
Order Pseudophyllidea. Scolex spatulate with bothria

Diphyllobothrium latum

Order Cyclophyllidea. Scolex globular with four cuplike suckers 1. Species which require vertebtrate IH

Taenia solium

Tanenia saginata
Diphyllidium caninum Hymenolepis diminuta

2. Species which require invertebrate IH

3. Species which may or may not require IH

Hymenolepis nana
Echinococcus granulosus Echinococcus multilocularis

4. . Species which may infect man in their larval stages

S.A. 2 TaeniaBasit solium

General Characteristics
adults are ribbon-like or tape-like in appearance

sizes varies from few mm to several meters

segmented hermaphroditic the body consists of three regions: 1. scolex 2. neck 3. strobila

S.A. Basit

Basic Parts of Cestodes

S.A. Basit

Basic parts of a tapeworm

Classification of segments accdg to development

immature segments

mature segments
gravid segments

S.A. Basit

Pseudophyllidea
spatulate with bothria uterine pore: present

Cyclophyllidea
globular scolex w/4 -

genital pore: center

no apolysis immature operculated

ova embryo: coracidium (ciliated) 2 IH 2 larvae 1. procercoid larva 2. plerocercoid larvae S.A. Basit

cup like suckers uterine pore: absent genital pore: side undergoes apolysis mature non operculated ova 1 IH 1 larva which could be: Cysticercus Cysticercoid Hydatid cyst

Pseudophllidea

Cyclophyllidea

Diphyllobothrium latum
Broad Fish tapeworm (Lumbricus latus, 1656)

Diphylobothriasis
Sparganosis unarmed scolex provided w/ bothria adult worm is ivory white measures 3-10 m or

more and may have as many as 3,000 proglottids

S.A. Basit

Ova - operculated

 eggs are ovoidal, operculated, moderately thick-

shelled, golden yellow, measures 58-76 by 40-51 um. coracidium-ciliated procercoid-measures 550 um in length w/ 3 pairs of hooklets plerocercoid-measures 6 mm in length, no scolex

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Adult D. latum

Scolex and Proglottides

Mature segment with mature reproductive organs

Pathology: adult infection

weakness, dizziness, abdominal discomfort

few suffers from bothriocephalus anemia

pernicious anemia

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Pathology: Larval Infection

spargana maybe recovered from eye, nose, neck,

brain, orbit Sparganosis: 1. ingestion of infected cyclops containing procercoid stage 2. ingestion of raw infected flesh of amphibians,reptiles,birds or mammals with sparganum 3. local application of the flesh of infected vertebrates to the skin 4. ingestion of raw pork
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Sparganosis

Diagnosis, Treatment, Prevention and Control

adult tapeworm infection is diagnosed by

recovery of the eggs in stool sparganosis- surgical removal Niclosamide and praziquantel against adult D. latum Prevention includes thorough cooking of freshwater fish and freezing of fish at 10 deg C for 24-48 hours. Sparganosis can be prevented by boiling or filtering of water.

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Taenia solium
Pork tapeworm (verme solitario) Taeniasis solium Cysticercosis adult worm measurtes 2-3 m in length head/scolex is globular in shape w/ 4 cup-shaped

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suckers scolex-rostellum armed with ac double row of hooklets egg is spherical, brown and measures 31-56 um in diameter it has 2 radially-striated shells, inside the embryo are 6 hooklets. S.A. Basit the larval stage is called cysticercus cellulosae

T. Solium scolex

Scolex in electron micrograph

Taenia ova with hexacanth embryo

Ovum is striated

Cysticercus cellulosae: the larva and infective stage isolated from measly pork

Segment with <13 uterine branches

Pathology: adult infection

presence of Taeniasis solium

- brought about by ingestion of raw or

insuffeciently cooked pork containing cysticercus celluloseae. - not so serious condition as compared to cysticercosis

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Pathology: Larval Infection

is quite serious it may affect the vital organs Human cysticercosis or larval taeniasis- infection

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with the larval stage caused by ingestion of eggs of T. solium or through regurgitation of eggs and gravid segments of the parasite into the stomach *Cysticercosis develops in the pigs tissue and the meat is termed MEASLY PORK The pathology produced however by the larval stage ( cysticercus cellulosae) is quite serious because it may lodge in the vital organs like S.A. Basit brain, spinal cord, heart liver, eyes, etc.) giving rise to pressure symptoms.

Brain cysticercosis

Cysticercosis

Lab Dx
demonstration of Taenia eggs in stool

T. solium is more pathogenic than T. saginata

segments of T. solium- less than 13 uterine lateral

branches as compared w/ T. saginata- more than 15 scolex: T. solium- w/ rostellum armed w/ spines T. saginata- neither rostellum nor spines cysticercosis: tissue biopsy (biopsy of nodules)

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 Treatment: Praziquantel, Niclosamide, Bithionol,

Praziquantel, Paromomycin
Prevention:avoid eating insufficiently cooked pork

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Taenia species
T. solium
armed scolex w/

T. saginata
unarmed scolex no

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rostellum <13 uterine branches IH: pig larva: cysticercus cellulosae cysticercosis pork tapeworm

rostellum >15 uterine branches IH: cattle larva: cysticercus bovis no cysticercosis beef tapeworm

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Taenia saginata
Common name: beef tapeworm producing

taeniasis saginata or beef tapeworm infection Adult is whitish, opaque in color, and measures on the average of 5-10 min. in length---15m. The worm is attached to the mucosa of the intestines by means of the scolex IH: cattle, carabao, goats

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S.A. Basit

Taenia saginata unarmed scolex without rostellum

Beef tapeworm mode of transmission

Actual length of beef tapeworm

Segment with genital pore

Pathology
more dangerous to be infected by T. solium than

with T. saginata because there seems to be no cysticercosis in man due to T. saginata. pathology caused by this parasite is mainly due to its large size which is responsible in the disturbance in the normal functions of digestive tract.

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Lab Dx
stool exam using concentration technique

gravid segments passed out by the patient can

be pressed between two slides and lateral uterine branches counted.

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Dipylidium caninum
Common name: dog tapeworm or double-

pored tapeworm producing dipylidiasis primarily a parasite of dogs but man is ocassionally infected by accidental ingestion of dog fleas containing the larvae proglottids have double set of reproductive organs and a genital pore on each lateral margin

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Scolex of dog tapeworm

Encapsulated ova of dog tapeworm

Pumpkin shape segment

Double-pored genital pore

Life cycle in dog

Actual size

Pathology
degree of pathogenicity depends on intensity of

infection consists of slight intestinal disturbances Common tapeworm of dog and cat but man is ocassionally infected by ingestion of dog fleas containing the larvae. infection more common among children suggesting their greater exposure

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Lab Dx, Treatment, Prevention and Control

based on recovery of a single or chain groups of

prolottids passed in the feces eggs in egg capsule are seldom seen in feces Quinacrine, niclosamide cats and dogs should be dewormed periodically insecticide dusting of dogs and cats to kill fleas

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Hymenolepis diminuta
Common name: rat tapeworm scolex small, club-shaped with 4-cup-shaped

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suckers mature segments of H nana and H diminuta are hard to distinguish pathology: similar to other tapeworm infection recovery of characteristic eggs from patients stool adult worms at times maybe expelled spontaneously man is ocassionally infected through accidental infection of invertebrae host. common parasite of rat, mouse and dog

S.A. Basit

Scolex

Ova of rat tapeworm

Ova

Cysticeroid larva

Immature segment

Mature segment

Gravid segment

Treatment, Prevention and Control

Quinacrine, niclosamide

eliminate rats and mice in houses

destruction of beetles, cockroaches and other

insects that act as intermediate host.

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Hymenolepis nana
dwarf tapeworm

0.5 to 9 cm; 96-840 segments

scolex: minute; rhomboidal with 4 cup-shaped

suckers and a short rostellum armed with a ring of 20 to 30 spines strobila: short, narrow proglottids gravid: completely filled with eggs eggs: spherical or subspherical hyaline measures 30 to 47 um

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Actual appearance

Ova

Scolex

Mature segment

Echinococcus granulosus
Common name: hydatid worm producing

unilocular echinococcus or hydatid disease smallest tapeworm parasitizing man consisting only of a scolex, neck, and 3 segments very rare infection in the Phil. common parasite of dogs, wolves, jackals, coyotes, and other canines

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Main parts of the worm

Scolex

Immature segment

Gravid segment

Pathology
growing cyst lodged in vital organs like liver,

lungs, brain, and heart interfere with the function of the organ. uniocular cyst found in the bone is called osseous hydatid cyst

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Worm in dogs intestine

Liver with infected hydatid cyst

Hydatid cyst

Lab Dx
unilocular cysts are diagnosed later in life only

after they have grown to a tremendous size. hydatid disease can be diagnosed by:
1. roentgenogram 2. exploratory cyst puncture 3. immunologic tests

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Radiographic Examination

Treatment
surgical removal of hydatid cyst

human infection results from fondling infected

dogs dogs should be prevented from eating carcasses of sheep, cattle, and hogs in endemic areas dogs should be dewormed periodically

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