PARASITOLOGY

Topic: Major Cestodes

References: Old Trans + Belizario

INTRODUCTION o Proglottids
 Commonly known as Tapeworms  Mature Proglottids
 Taxonomy: - Square
o Phylum: Platyhelminthes - Contain both mature male and female
o Class: Cestoda reproductive organs:
o Order: Cyclophyllidea Female  there are two large lobes of
 Taenia solium ovaries and a median club-shaped
 Taenia saginata uterus; vagina is marginally located
o Order: Pseudophyllidea with a sphincter muscle
 Diphyllobothrium latum Male  follicular testes numbering
 Spirometra spp. 300 to 400 are scattered throughout
 Flattened dorsoventrally the proglottid
 Absence of alimentary tract; takes in nutrients via its integument
 Requires 1 or more intermediate host  Gravid Proglottids
o Syntegument – outer anucleate syncytial cytoplasmic - Diagnostic stage
layer containing numerous mitochondria and secretory - Contains 97,000 to 124,000 ova
bodies (594,000,000 ova are passed out annually)
 Parts: - Longer and wider (16-20 mm by 5-7 mm)
o Scolex – organ of attachment; infection persists as long - Most distal from the neck
as the organism is attached to the intestinal wall - The uterus is distended with ova and has
o Neck 15 to 20 lateral branches
o Proglottid – chain of few to many egg-producing units - The genital pores of proglottids are
 Immature proglottids irregularly alternate
Develops from the distal end of the neck. - Undergo apolysis  gravid proglottids
The units are just being differentiated and are separated and passed out with feces;
sexual organs are still immature free proglottids oviposits eggs in the
perianal region
 Mature proglottids
Larger units which contains male and  Ova
female genital organs (Hermaphroditic) o Spherical or Subspherical
o 30 to 45 μm in diameter
o The original thin outer membrane surrounding the egg is
 Gravid proglottids
rarely retained after passage from the proglottid
These are farthest away from the scolex;
o Brownish in color
contains the fully developed uterus with
o With a thick embryophore which appears striated
eggs
because of numerous pits
o Inside the eggshell is the oncosphere or embryo provided
Taenia saginata
with three pairs of hooklets
 Common name: Beef tapeworm
 Definitive host: Human Life Cycle
 Habitat: Jejunum Based on Belizario:
 Upon ingestion of the T. saginata eggs by cattle, the oncosphere is
Parasite Biology released
Morphology  The oncosphere actively penetrates the intestinal mucosa, enters a
venule, and is carried to other parts of the body
 It typically enters a muscle fiber and develops into an infective stage
called Cysticercus bovis in 2 months
 The cysticercus is ovoidal, milky white, about 10 mm in diameter, and
has a single scolex invaginated into a fluid-filled bladder
 Humans readily become infected when these encysted larvae are
ingested from raw or improperly cooked beef
 The larva is digested out of the meat, and the scolex evaginates to
 Adult worm attach to the mucosa of the small intestines where it will become
o 4 to 10 m in length (or up to 25 m in length) mature in about 12 weeks
o May have 1,000 to 4,000 proglottids  Usually, only one adult tapeworm is present in T. saginata infections
o Scolex  The adult seems to be irritated by alcohol, and passage of proglottids
 Cuboidal sometimes results after a drinking bout
 1-2 mm in diameter  While humans are suitable intermediate hosts for T. solium, they are
 4 acetabula not for T. saginata
 Absent hooks or rostellum
o Neck
 Short
 It is attached to the scolex
 It is where a chain of immature, mature, and
gravid proglottids develop

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 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario

Diagnosis
 Specific diagnosis rests on identifying the characteristic proglottids,
eggs or scolex
 The first specimen usually brought in by patients are the gravid
proglottids, either single or in chains
o They are passed out with the feces or may be recovered
in the patient’s undergarments
o Gravid proglottids are pressed or flattened in between
two glass slides and are examined against the light
This will allow one to have a rough count of the lateral
branches from the main uterus

o Injection of India ink through the genital pore will help

one make an accurate count of the lateral branches of the
uterus
o Mature segments can be stained to demonstrate the
vaginal sphincter for T. saginata
 Examination of the stool can be done for the presence of eggs, but
eggs are IRREGULARLY passed out with the stools
Taeniasis is the infection of humans with the adult tapeworm of Taenia saginata or Taenia o Concentration techniques like the formalin-ether/ethyl
solium. Humans are the only definitive hosts for T. saginata and T. solium. Eggs or gravid acetate concentration technique will be useful in
proglottids are passed with feces (1); the eggs can survive for days to months in the increasing the chance of demonstrating the eggs
environment. Cattle (T. saginata) and pigs (T. solium) become infected by ingesting o Perianal swabs may also be useful because eggs are left
vegetation contaminated with eggs or gravid proglottids (2). In the animal’s intestine, the in the perianal skin as the gravid segments squeeze out
oncospheres hatch (3), invade the intestinal wall, and migrate to the striated muscles,
of the anal opening
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 (4). In the human
Treatment
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 (5) and reside in  Praziquantel – 5 to 10 mg/kg as a single dose
the small intestine (6). Length of adult worms is usually 5 m or less for T. saginata (however  Niclosamide
it may reach up to 25 m) and 2 to 7 m for T. solium. The adults produce proglottids which  It is not necessary to recover the scolex unless species-specific
mature, become gravid, detach from the tapeworm, and migrate to the anus or are passed diagnosis is needed
in the stool (approximately 6 per day). T. saginata adults usually have 1,000 to 2,000
 Criteria for the cure include the following:
proglottids, while T. solium adults have an average of 1,000 proglottids. The eggs contained
in the gravid proglottids are released after the proglottids are passed with the feces. T.
o Recovery of the scolex
saginata may produce up to 100,000 and T. solium may produce 50,000 eggs per proglottid o A negative stool examination 3 months after treatment
respectively.
Taenia solium
Taenia saginata/solium:  Common name: Pork tapeworm
 Infective stage: Oncosphere  Taenia solium eggs can cause cysticercosis
 Diagnostic stage: Eggs or Gravid proglottids in feces  Has cosmopolitan distribution
 Intermediate host: Cows, Pigs  Man  serve as both definitive host & intermediate host
 Definitive host: Humans  Both intestinal & tissue infections occur in man

Pathogenesis & Clinical Manifestations Parasite Biology

 The most common chief complaint is the passage of proglottids or Morphology
segments in the stool
 T. saginata causes mild irritation at the site of attachment
 Patients with taeniasis may experience nonspecific symptoms:
o Epigastric pain
o Vague discomfort
o Hunger pangs
o Weakness
o Weight loss
o Loss of appetite  Adult worm
o Pruritus ani (perianal itching) o Inhabits the upper small intestines
 Rarely, entangled proglottids may result in intestinal obstruction o It derives nourishment from intestinal contents of the
Individual T. saginata proglottids are actively motile and they host
have been documented to cause obstruction in the bile and o It is shorter than T. saginata
pancreatic ducts, as well as the appendix o Has less number of proglottids
o 2-4 m in length
 The sight of actively motile proglottids in the perianal area and in the o May have 8,000 to 10,000 proglottids
undergarments may result in anxiety and distress
Continued next page…..

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 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario

Adult worm continued…..

o Scolex:
 4 acetabula
 Smaller (1 mm)
 More spherical
 Carries a cushion-like rostellum with a
double crown of 25-30 large & small hooks
o Neck
 Part next after the scolex
 It is where the proglottids develop
o Proglottids
 Resembles T. saginata
 The difference lies in the:
 Presence of an accessory ovarian
lobe
 Absence of a vaginal sphincter
 Smaller number of follicular testes
(100- 200) in the mature proglottid
of T. solium

 Gravid Proglottids
- Contains 7-13 lateral branches
- Less active than T. saginata
- Contains 30,000 to 50,000 ova
- Undergo apolysis to eventually release
eggs, which remain viable for weeks

 Eggs
o Indistinguishable from T. saginata Cysticercosis is an infection of both humans and pigs with the larval stages of the parasitic
o 30 to 45 μm cestode, Taenia solium. This infection is caused by ingestion of eggs shed in the feces of a
o With thick brown striated embryophore surrounding a human tapeworm carrier (1) . These eggs are immediately infectious and do not require a
developmental period outside the host. Pigs and humans become infected by ingesting eggs
hexacanth embryo
or gravid proglottids (2) , (7) . Humans are usually exposed to eggs by ingestion of
o The eggs are ingested by hogs and the oncospheres are food/water contaminated with feces containing these eggs or proglottids or by person-to-
released in the intestines person spread. Tapeworm carriers can also infect themselves through fecal-oral
transmission (e.g. caused by poor hand hygiene). Once eggs or proglottids are ingested,
Life Cycle oncospheres hatch in the intestine (3) , (8) invade the intestinal wall, enter the
Based on Belizario: bloodstream, and migrate to multiple tissues and organs where they mature into cysticerci
 The oncosphere penetrates the intestinal mucosa to typically encyst over 60–70 days (4) , (9) . Some cysticerci will migrate to the central nervous system,
in muscles as cysticercus cellulosae causing serious sequellae (neurocysticercosis).

 The cysticercus may be found in all tissues
 Commonly, infected are the muscles, tongue, heart, diaphragm, liver,
spleen, and mesentery
 Infected meat is often called “measly pork”
 Upon ingestion of improperly cooked infected meat, the larva is
liberated and the scolex attaches to the intestinal mucosa
 Maturity is attained in approximately 12 weeks from the time of
ingestion of the cysticercus
 Man may also be an intermediate host of T. solium
 Taenia eggs are very resistant and when the eggs are ingested,
development to cysticerci ensues as it does in pigs
 The oncosphere hatches in the duodenum, and spreads to different
organs through the bloodstream  this results in human
cysticercosis
 The mature cysticercus is oval, translucent, and has an opaque
invaginated scolex with four suckers and a circlet of hooks
It is usually encapsulated with adventitious host tissue
However, in the vitreous humor and in the brain, it may be
unencapsulated. A full size of 5 mm may be attained in 10 weeks
 Human infection with cysticercus cellulosae can be acquired through
fecal-oral route by ingesting Taenia solium eggs from contaminated
food or drink
 Individuals harboring the adult Taenia solium can infect themselves
(autoinfection) due to poor hygienic practice
This differs from taeniasis, which is an intestinal infection with the adult tapeworm. Humans
acquire intestinal infections with T. solium after eating undercooked pork containing
cysticerci (5). Cysts evaginate and attach to the small intestine by their scolices. Adult
tapeworms develop to maturity and may reside in the small intestine for years (6)
Pathogenesis & Clinical Manifestations
A. Intestinal Infection
 T. solium intestinal infection results in mild non-specific abdominal
complaints
 Unlike in T. saginata infections, proglottids are not as active and,
therefore, obstruction of the bile duct, pancreatic duct, or the
appendix is UNLIKELY
B. Cysticercosis
 The cysticerci are often multiple and can develop in any organ or
tissue
 Most commonly, they are located in striated muscle and in the brain,
but the subcutaneous tissues, eye, heart, lung, and peritoneum may
be involved
 The living cyst may produce inflammation
 Cysts may survive up to 5 years  upon death, cystic fluid increases
and there is a pronounced tissue response to the parasite  the
parasite is eventually calcified
 Symptomatology is dependent on the number, size, and location of
the lesion

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 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario
Cysticercosis continued…..
 Neurocysticercosis (NCC)
o One of the most serious manifestations
o Most serious zoonotic diseases worldwide
o Cysticerci containing a scolex may be found in the brain
parenchyma or floating freely in the ventricles
o Cysticerci may also appear as large vesicular structures
devoid of a scolex and are usually located in the basal
cisternal spaces
o NCC is divided into 2 general forms:
 Parenchymal
 Extraparenchymal:
 Subarachnoid
 Meningitic
 Intraventricular
 Spinal
o Clinical manifestations and corresponding management
depend on the form of NCC present in the patient
Parenchymal NCC:
o Focal neurologic deficits are usually encountered in
parenchymal NCC
o They would depend on the location of the cysts
o Focal or generalized seizures are observed when cysts
are located in the cortex
Extraparenchymal NCC:
o The subarachnoid form may lead to an aggressive form
of NCC called racemous cysticercosis
In this form, there is a proliferation of cysts in the base
of the brain. This form has a poor prognosis
o In the intraventricular form, cysts are usually present in
the third or fourth ventricle and often lead to obstructive
hydrocephalus
o The spinal form is rare
 The death of the larva leads to inflammation of the affected region
 Calcification is the end-result of the cellular reaction
 Convulsions are the most common manifestations of cerebral
cysticercosis
o Visual and motor deficits, headache, and vomiting may
occur
o Cerebrospinal fluid (CSF) tap results may show an
increased opening pressure, elevated protein
 In the eyes, cysticerci are often retinal or subretinal in location
 They may float freely in the vitreous or aqueous humors
 Vision is usually affected due to chorioretinitis and vasculitis
 Detachment of the retina has also been reported
 The patient may complain of:
o Intraorbital pain
o Photopsia
o Blurring or loss of vision
Diagnosis
A. Taeniasis
 Specific diagnosis of taeniasis rests on identifying the characteristic
proglottids, eggs, or scolex
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B. Cysticercosis
 CSF abnormalities:
o ↑ protein
o ↓ glucose
o ↑ mononuclear cells
 CAT scan (Computed axial tomography) and MRI
o Useful for localizing cysticerci and evaluating the
pathology before and after treatment
 3 main CAT scan patterns:
1. Round low-density area without surrounding
enhancement after administration of contrast dye
 Shows viable larva with no inflammation
2. Ring-like enhancement after injection of contrast dye
 A dead larva
3. Small calcified area within a cystic space
 Shows a dead scolex
 Opthalmic cysticercosis
o Diagnosed through the visualization of the cysticerci using
ophthalmoscopy but the procedure may induce
movement and/or evagination of the scolex
 Muscular & Subcutaneous cysticerci
o Usually palpable and can be recovered through tissue
biopsy for histopathologic processing
 Serologic Tests:
o Serum & CSF ELISA
o Electro-immuno transfer blot (EITB)
o Western blot  for specific IgG and IgM anticysticercal
antibodies
o Dot-ELISA test  is a very good screening test for
cysticercosis
Treatment
A. Taeniasis
 Praziquantel - 5 to 10 mg/kg, single dose
 Niclosamide – not available locally
 Criteria for cure include the following:
o Recovery of the scolex
o A negative stool examination 3 months after treatment
B. Cysticercosis
 Management of NCC depends on the form present in the patient
 Multiple Parenchymal cystic lesions:
o Praziquantel – 50 to 75 mg/kg divided into 3 doses for 30
days
o Albendazole – 400 mg twice daily for 8 to 30 days
o Corticosteroids – given 4 hrs. after the last dose
80 mg of prednisone
or 10 mg of IM dexamethasone
 Cysticercotic encephalitis
o Corticosteroid therapy
 Subarachnoid form:
o Surgical removal of the lesions
o Albendazole – 10 to 15 mg/kg for 8 days
 Ventricular forms
o Surgical removal of cyst
 Ocular cysticercosis
o Treated surgically before praziquantel or albendazole is
given
 Symtomatic cysts outside the CNS
o Surgically removed
Page 4 of 7
 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario

Diphyllobothrium latum  Eggs/Ova

 Common name: Fish tapeworm or Broad tapeworm o Yellowish brown
 Also known as Jewish housewives’ disease (because they have the o Moderately thick shell
tendency to taste raw fish that they are about to book) o Inconspicuous operculum
 Order: Pseudophyllidae o Opposite the operculum is a small knob-like thickening
 Diphyllobothriasis refers to the intestinal infection with the adult
worm Life Cycle
Based on Belizario:
 With distention of the uterus, the uterine pore is relaxed and unembryonated
Parasite Biology
ova are discharged from the proglottid
Morphology  Approximately 1,000,000 ova may be released daily
 The ova complete their development in water and release the free-swimming
coracidium, a ciliated embryo, which is ingested by freshwater copepods of
the genera Cyclops and Diaptomus
 A procercoid larva develops in the copepod
The procercoid measures 550 µm and still retains the three hooklets in the
cercomer, a caudal attachment organ

 The copepod is in turn ingested by fish

 The procercoid larva migrates through fish tissues and develops into a
plerocercoid larva in the muscles and viscera
The plerocercoid larva or sparganum measures 20 mm or more and
appears glistening, opaque white, and unsegmented

 Adult worm  Fish with the infective plerocercoid larva is ingested raw by a definitive host
like man, dog, cat, and other mammals
o 3 to 10 m in length
In the definitive host, the plerocercoid attaches to the intestinal wall and
o May have 4,000 proglottids reaches maturity in about 3 weeks
o Scolex
 Spatulate  Carnivorous fish may serve as paratenic or transport hosts as well
 It has two bothria or sucking grooves  are  Among fish intermediate hosts are perch, trout, salmon, and pike
located dorsally and ventrally
o Neck
 Long and attenuated
 Is followed by immature proglottids
o Proglottids
 The terminal four-fifths of the worm is
composed of mature and gravid proglottids
 Mature Proglottids
- Has a longer width than its length
- 2 to 4 mm in length by 10 to 12 mm in
width
- Contains one set of reproductive organs
- The testes are located in the dorsolateral
part of the proglottid
- The vas efferens converge to form a vas
deferens and this enlarges into a seminal
vesicle and terminates in a muscular
cirrus found at the midventral common
genital pore
- The dark, rosette-like, coiled uterus
Eggs are passed unembryonated in feces (1) . Under appropriate conditions, the eggs
located in the middle of the gravid mature (approximately 18 to 20 days) (2) and yield oncospheres which develop into a
proglottid extends from the ootype and coracidia (3) . After ingestion by a suitable crustacean (first intermediate host) the coracidia
opens through a uterine pore in the develop into procercoid larvae (4) . Procercoid larvae are released from the crustacean upon
midventral line behind the common predation by the second intermediate host (usually a small fish) and migrate into the deeper
genital pore tissues where they develop into a plerocercoid larvae (spargana), which is the infectious
- A symmetrical bilobed ovary is present stage for the definitive host (5) . Because humans do not generally eat these small fish
species raw, the second intermediate host probably does not represent an important source
at the posterior third of the proglottid
of human infection. However, these small second intermediate hosts can be eaten by larger
immediately above the Mehlis’ gland predator species that then serve as paratenic hosts (6) . In this case, the plerocercoid
- From the common genital pore, the migrates to the musculature of the larger predator fish; humans (and other definitive host
vagina extends up to join the oviduct and species) acquire the parasite via consumption of undercooked paratenic host fish (7) . In the
the vitelline duct definitive host, the plerocercoid develops into adult tapeworms in the small intestine. Adult
diphyllobothriids attach to the intestinal mucosa by means of two bilateral groves (bothria)
o Unlike in Taeniidae, the proglottids of D. latum of their scolex (8) . The adults can reach more than 10 m in length, with more than 3,000
proglottids. Immature eggs are discharged from the proglottids (up to 1,000,000 eggs per
disintegrate only when the segment has completed its
day per worm) and are passed in the feces. Eggs appear in the feces 5 to 6 weeks after
reproductive function infection

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 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario

Pathogenesis & Clinical Manifestations Spirometra spp.

 Infections are usually limited to one worm, although there have been  Sparganosis refers to the larval infection with the plerocercoid
reports of mechanical obstruction due to a large number of worms larvae, also known as spargana, of pseudophyllidean tapeworms
 Infected individuals may show no signs of disease falling under the Genus Spirometra
 Some, however, may experience:  Adults of these worms are intestinal parasites of cats, dogs, and other
o Nervous disturbances carnivores
o Digestive disorders
o Abdominal discomfort Parasite Biology
o Weight loss Morphology
o Weakness  Adult worm:
o Anemia o The gravid proglottids of Spirometra sp. have a spiral
 Symptoms may be due to absorbed toxins or by-products of uterus, in contrast to the rosette uterus observed in
degenerating proglottids, or due to mucosal irritation Diphyllobothrium sp.
 D. latum infections results in hyperchromic, megaloblastic anemia  Eggs:
with thrombocytopenia and leukopenia o Spirometra eggs are operculated and immature, similar
 Anemia seen in diphyllobothriasis is typically similar to that seen in to those of Diphyllobothrium, although smaller
Vitamin B12 deficiency and could be mistaken for pernicious anemia.
Worms located high up in the jejunum compete effectively with  Larvae:
the host for the Vitamin B12 in the diet o Opaque and glistening white
o 3.5 cm in length
 If worms are pushed further down the intestines, with treatment, o When the larvae are flattened, a spatulate scolex can be
anemia is relieved appreciated, together with pseudosegmentation, and a
 The vitamin B12 content of D. latum is approximately 50 times that slit like invagination at the anterior end
of T. saginata
Life Cycle
Diagnosis
 Definite diagnosis is made on finding the characteristic operculated
eggs or proglottids in stools
 Sometimes, proglottids may be vomited
 Since eggs are usually numerous, direct fecal smears usually suffice
o The Kato technique is also useful in demonstrating eggs
 To differentiate anemia due to diphyllobothriasis from pernicious
anemia, examination of the gastric juice for the presence of free
hydrochloric acid is useful
o Pernicious anemia is associated with achlorhydria

Treatment
 Praziquantel – 5 to 10 mg/kg single dose
 The criterion for cure is:
o Recovery of the scolex in feces after treatment
o If the scolex is not recovered, a repeat stool examination
is done after 3 months to be certain that the patient is no
longer infected
Adult members of the genus Spirometra live in the intestines of dogs and cats (7). Eggs are
Diphyllobothrium latum: shed in feces (1) and embryonate in the environment (2). Eggs hatch in water and release
 Infective stage to copepods: Coracidium coracidia (3), which are ingested by copepods. The coracidia develop into procercoid larvae
 Infective stage to fish: Precercoid larva in the copepod intermediate host (4). Second intermediate hosts, including fish, reptiles and
amphibians, ingest infected copepods and acquire procercoid larvae. The procercoid larvae
 Infective stage to humans: Plerocercoid larva
develop into plerocercoid larvae in the second intermediate host (5). The cycle is completed
 Diagnostic stage: Unembryonated eggs in the feces when a predator (dog or cat) eats an infected second intermediate host (6). Humans cannot
 1st intermediate host: copepods serve as definitive hosts for Spirometra spp., but serve as paratenic or second intermediate
 2nd intermediate host: fish hosts (8) and develop sparganosis. Humans acquire sparganosis by either drinking water
 Definitive host: Humans and some mammals contaminated with infected copepods or consuming the flesh of an under-cooked second
intermediate or paratenic host. Spargana can live up to 20 years in the human host.

Continued next page…..

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 PARASITOLOGY
Topic: Major Cestodes
References: Old Trans + Belizario

Based on Belizario: Additional Information from Old Transes:

 Spirometra eggs are passed out with the feces of the definitive hosts  Larva
and become embryonated in water o L1 – coracidium; ciliated oncosphere
 The coracidium, once released, infects Cyclops and develops into the o L2 – procercoid; spindle-like body with cephalic
procercoid larva invagination; retains hooklets; found in 1st IH
 Once the infected Cyclops are ingested by the secondary o L3 – plerocercoid; invaginated at the neck; found in the
intermediate hosts such as frogs, snakes, and chickens, the 2nd IH and reaches maturity in about 3 weeks; infective
procercoid larva develops into the plerocercoid larva which is also stage in man
known as sparganum (pl. spargana)
 If the infected tissues of the second intermediate host are ingested Cestodes
by the definitive host (cats and dogs), the plerocercoid larva develops  Intestinal Tapeworm
into an adult worm o Diphyllobothrium latum
 These adults are usually mistaken for adult Diphyllobothrium latum, o Hymenolepis nana
although Spirometra sp. adults are shorter o Hymenolepis dimunata
o Dipylidium caninum
Pathogenesis & Clinical Manifestations o Taenia saginata
 Humans may be infected through: o Taenia solium
o Drinking water containing Cyclops or copepods infected  Extra-intestinal Tapeworm
with procercoid larvae o Echinococcus granulosus
o Eating infected second intermediate hosts like frogs, o Echinococcus multicolaris
toads, or snakes containing the plerocercoid larvae o Cysticercus cellulosae
o Applying plerocercoid infected flesh of frogs and snakes o Spargana (Spirometra)
as poultices on sores on the eye, vagina, and skin resulting
in subsequent penetration into cutaneous tissues Pseudophyllidean Cyclophyllidean
o Consumption of infected flesh of paratenic hosts like wild Diphylloborthrium latum Taeia solium
pigs Spirometra spp. Taenia saginata
 The resulting condition is called sparganosis Hymenolepis nana
 The larvae may be found in any part of the body. Hymenolepis dimunata
 Most commonly, they are found in and about the: Dipylidium caninum
o Eyes Echinococcus granulosum
o Subcutaneous and muscular tissues of the thorax,
abdomen, thighs, inguinal region, and in the viscera
 Patients may complain of painful edema due to migrating larvae, References:
hence, the condition is also known as migrating tumor  Medical Parasitology in the Philippines by
Belizario & de Leon (3rd Ed.)
 Local indurations, periodic giant urticaria, edema, and erythema with
 Lecture Notes
chills, fever, and high eosinophilia may be seen in patients

Diagnosis
 Sparganosis is diagnosed through the recovery of the plerocercoid
larvae from infected tissues

Treatment
 Surgical removal of the larvae from infected tissue  main
treatment
 Praziquantel

Spirometra spp.:
 1st intermediate host: Cyclops or Copepods
 2nd intermediate host: Frogs, Snakes
 Definitive host: Dogs and Cats
 Accidental host: Human
 Infective stage to human and dogs: Procercoid larva in Cyclops,
Plerocercoid larva in 2nd IH
 Diagnostic stage: Unembryonated Eggs

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