General characteristics Larval and Juvenile Development

- adults found in humans all have a flat and ribbonlike body Embryogenesis within the egg to result in a larva, the oncosphere
C
- living worms are white or yellowish
E
- body consists of an anterior attachment organ, or scolex, followed by a chain of segments or Hatching of the oncosphere after or before being eaten by the next host where it
S
proglottids, also known as strobila penetrates to a parenteral (extraintestinal) site
T
O - strobila grows throughout the life of the tapeworm by continuous proliferation of new segments
or proglottids in the region immediately posterior to the scolex Metamorphosis of the larva in the parenteral site into a juvenile (metacestode)
D
- new segments are referred to as immature because they do not yet contain fully developed usually with a scolex
E
S internal structures
- mature segments are larger and are found near the middle of the chain, and each may contain Development of an adult from the metacestode in the intestine (enteral site) of the
or
either one or two sets of both male and female reproductive organs same or another host
C - terminal portion of the strobila contains the ripe or gravid segments usually filled with eggs
l - eggs are enclosed in the uterus, a structure that varies in shape and size in different cestode
Oncospheres that have three pairs of hooks are also referred to as hexacanth
a species
s - terminal proglottids of some species may become detached in the intestine and pass out with the Free –swimming oncospheres hatching from an egg that have a ciliated inner
s stool; some types may be too small to be seen in gross examination envelope are called coracidia
- adults inhabit the small intestine, where they live attached to the mucosa Larvae with ten hooks (decacanths), are also ciliated and are called lycophoras
C - attachment is accomplished by means of the scolex (vary from species to species) Embryophore – name applied both to the full ciliated inner envelope of a coracidium,
e - all cestodes of humans have four muscular, cup-shaped suckers on the scolex and to a specialised intracellular proteinaceous lamina produced within the inner
s - in addition to suckers, scolex may have an elongate and protrusible structures , the rostellum, envelope of a cestode with a non-swimming oncosphere. (Note: some authorities
t situated in the center of the scolex prefer to distinguish the motile inner envelope of a coracidium by referring to it as a
o - in some species the rostellum bears hooks and is referred to as armed “ciliated embryophore”.)
i - while precise identification of the tapeworms of humans is usually made on the basis of the eggs Types of
d or proglottids, the scolex of each species is quite characteristic and is sufficient for identification Cestode
e - no digestive system; food is absorbed from the host’s intestine Metacestodes
a - human cestodes have complex life cycles that generally involve both a definitive and an
intermediate host
or - some utilize humans only as definitive hosts, growing to adulthood in the intestine after ingestion
of the infective larvae (eg., D. latum, Taenia saginata, Hymenolepis diminuta)
t - for some species, humans are equally acceptable as definitive or intermediate hosts (eg., Taenia
a solium, Hymenolepis nana)
p - others, such as Echinococcus, utilize humans as one of their possible intermediate hosts, but
e never as definitive host
w - extraintestinal infection with the larval forms is a much serious matter than infection with the
o adult worm
r - eggs vary considerably in appearance of the external shell as well as in the number and thickness
m of the embryonic membranes (membranes serve as protective coverings of the embryo, which is
s called an oncosphere and bears six elongate hooks)
 Taeniasis
- Parasite: Taenia saginata (beef tapeworm) or Taenia solium (pork tapeworm) - Location of adults in humans : attached to small intestine
- Means of human infection : ingestion of larvae in beef or pork - Clinical features : vague digestive disturbances, anorexia; majority asymptomatic
- Location of larvae in humans : not present for T. saginata; subcutaneous tissues, muscle, eye, - Laboratory diagnosis : embryonated eggs or proglottids in stool
brain for T. solium

S. name Taenia saginata (1) Taenia solium (2)

C. name beef tapeworm pork tapeworm
Gen. - human serves ONLY as a definitive host and NEVER as intermediate host - human serves as definitive and intermediate host (intestinal and tissue infection)
Charac. - adult inhabits the upper jejunum for up to 25 years - adult inhabits the upper small intestine
- measures 4 to 10 m in length and may have 1000 to 4000 proglottids
- measures 2 to 4 m in length and may have 800 to 1000 proglottids
- cuboidal scolex with four prominent acetabula or suckers
Adult - devoid of hooks or a rostellum - with short neck from which a chain of immature,
- scolex has four acetabula and a cushion-like rostellum with a double crown of 25 to 30
mature, and gravid proglottids develop
large and small hooks
- hermaphroditic
- wider than long or approximately square in shape - wider than long; morphology resembles that of T. saginata
Mature - two large lobes of ovaries and a median club-shaped uterus - presence of accessory ovarian lobe
Proglottid - follicular testes numbering 300 to 400 are scattered throughout the proglottid - smaller number of follicular testes
- vagina has sphincter - absence of vaginal sphincter
- longer than they are wide
- uterus distended with ova - longer than wide
Gravid - has 15 to 20 lateral branches - contains 7 to 15 lateral branches
Proglottid - contains 97000 to 124000 ova - approximately 30000 to 50000 ova
- undergo apolysis and are either passed out of the feces or actively crawl out of the - undergo apolysis and relatively less active (not observed to actively crawl)
bowel
- spherical or subspherical in shape measuring 30 to 45 um in diameter
- brownish in color with a thick embryophore which appears striated because of
Egg same as T. saginata
numerous pits
- inside the eggshell is the oncosphere or embryo provided with three pairs of hooklets
- identification of characteristic proglottids, eggs, or scolex
- speciation of Taenia is impossible if solely based on microscopic examination of eggs,
Diagnosis because all Taenia species produce eggs that are morphologically identical. Eggs of same as T. saginata
Taenia sp. are also indistinguishable from those produced by cestodes of the genus
Echinococcus
Treatmt Praziquantel Praziquantel and niclosamide
Inf. Stg. Cysticercus (specific: Cysticercus bovis) Cysticercus (specific: Cysticercus cellulosae)
Larval Cysticercus bovis Cysticercus cellulosae
 form
Cysticercosis
General Characteristics Cysticercus cellulosae
Infection with the larval form of Taenia solium, T. saginata, T. crassiceps T. ovis, T. - often multiple and can develop in any organ or tissue but most commonly in striated muscles
taeniaeformis or T. hydatigena is called cysticercosis. The larvae of these organisms are called and in the brain, subcutaneous tissue, eye, heart, lung, and peritoneum
cysticerci (singular: cysticercus) or bladder worm - most serious manifestation is neurocysticercosis
- produce local inflammation and may survive up to 5 years
- when these stages were first discovered, their relationship to the adult worm was not known, - calcification is the end result of the cellular reaction
and they were therefore given generic and specific names of their own; thus the bladder worm - clinical features : asymptomatic to Jacksonian seizures, hydrocephalus, visual problems
of T. solium was known as Cysticercus cellulosae - laboratory diagnosis : X-ray, CT, MRI, serologic tests
- means of human infection: ingestion of eggs - treatment : Praziquantel or albendazole; surgical removal of the cyst

S. name Multiceps multiceps (3) Raillietina garrisoni (4)

C. name Coenurus  tapeworm (not in pdf) common rat tapeworm (not in pdf)
-also known as Taenia multiceps
- Coenurus Disease
- adult of moderate size is found in dogs and other Canidae
Gen. - common tapeworm of rats
- larval stage, known as coenurus, occurs in a variety of herbivorous mammals and
Charac - accidental infection on humans through ingestion of intermediate host found in
has been reported occasionally from humans
stored grain products
- most common intermediate host : sheep (parasite produces a disease known as gid,
from the unstable gait, or giddiness, that marks the infected animals)
- humans mostly have coenuri in the brain and spinal cord
S. name Multiceps multiceps (3)
C. name Coenurus  tapeworm (not in pdf)
The adult worm is found in dogs and other canidae. The intermediate hosts comprise
of a number of herbivorous animals, where the cysts develop in the brain and spinal
cord causing a disease called ‘staggers’ or ‘Gid’, which affects the balancing powers
of the animals.
Man becomes infected by the accidental ingestion of eggs. The oncosphere hatches
and penetrates the intestinal wall and the embryo is carried by the blood stream to
various parts of the body, in the same manner as larvae of Taenia, including the
central nervous system where it lodges and the cyst or coenurus develops
The larval tapeworms occur in large groups within a single cyst known as a coenurus.
Life Cycle The coenurus may be as large as a hen's egg.
The meat of a carcass infected with the intermediate stage of T. multiceps is
considered to be suitable for human consumption if only a few cysts are present and
if they are removed. If, however, numerous cysts are present in the meat the entire
carcass should be judged unsuitable for human use.
The parasite is not transmissible to man from the intermediate hosts.
In tropical Africa, coenurus larvae, which may be those of a species other than M.
multiceps, have been found in the muscles or subcutaneous tissues.
A preoperative diagnosis of coenurus infection is unlikely, as there are no specific
serologic tests for it.
Inf. Stg. Cysticercus (not in pdf)
Treatmen
t surgical (no reports of the use of praziquantel or albendazole)
Raillietina garrisoni (4)
---------------------
Adult (NO LIFE CYCLE PIC IN PDF)
- about 60 cm in length with a minute, subglobular scolex with four acetabula
- rostellum is armed with two alternating circular rows of 90 to 140 hammer-shaped
hooks
- several rows of spines also surround the rostellum
Mature Proglottid
- bilobed ovary surrounded by 36 to 50 ovoid testes
- genital pore opens on the side near the anterior lateral border of the segment
Gravid Proglottid
- about 2 mm in length containing 200 to 400 egg capsules with 1 to 4 spindle-shaped
eggs
- will detach from the rest of the strobila by apolysis and may be passed out in the
feces
- motile, white, and appear like grains of rice in the feces
- may be ingested by the intermediate host (flour beetle, Tribolium confusum)
Eggs
- one to four spindle-shaped eggs in 1 egg capsule
- oncosphere is enclosed in two thin membranes: an outer elongated membrane and
an inner spherical membrane
Cysticercoid (not in pdf)
Praziquantel & sometimes complete expulsion of the worm without treatment
S. name Hymenolepis nana (5) Hymenolepis diminuta (6) Dipylidium caninum (7) Diphyllobothrium latum (8)
C. name dwarf tapeworm rat tapeworm double-pored dog tapeworm (not in pdf) fish tapeworm or broad tapeworm
- common in cats and dogs; accidentally in
-smallest tapeworm humans especially children because of
- common parasite of rat
- common parasite of house mouse their close contact with their pets
- requires an arthropod intermediate host
- the only human tapeworm which can - adults not commonly infected possibly
(flour moths, flour beetles, fleas, - infection is dependent on the presence
Gen. complete its entire life cycle in a single because of age tolerance against this
cockroaches, mealworms, earwigs) of different hosts, dietary habits, and
Charac host (does not require an obligatory parasite
- human infection through accidental environmental sanitation
intermediate host) - presence of actively motile proglottids in
ingestion intermediate hosts infesting
- humans can harbor both the adult and feces or underwear can be observed
dried grains, dried fruits, flour and cereals
the larval stages - requires an intermediate host (fleas and
dog louse)
- resides in the ileum
- delicate strobila measuring 25 to 45 mm
in length and 1 mm in width - 3 to 10 m in length and may have 4000
- pale reddish, measures 10 to 70 cm in
- subglobular scolex with four cup-shaped proglottids
- about 60 cm in length (larger than H. length
suckers - scolex is spatulate and measures 2 to 3
nana) - scolex is small and globular with four
Adult - retractable rostellum armed with a single mm in length by 1 mm in diameter
- scolex with a rudimentary unarmed deeply cupped suckers and a protrusible
row of 20 to 30 Y-shaped hooklets - has two bothria or sucking grooves which
rostellum rostellum which is armed with 1 to 7 rows
- anterior proglottids are short and the are located dorsally and ventrally
of rose thorn shaped hooklets
posterior ones are broader than long - neck is long and attenuated
- genital pores are found along the same
side of the segments
Proglot Mature Proglottids Proglottids Mature Proglottids Mature Proglottid
tid - three ovoid testes and one ovary in a - closely resembles that of H. nana (see - narrow with two sets of male and female - longer width than length (10 to 12 mm x
more or less straight pattern across the reference) reproductive organs and bilateral genital 2 to 4 mm)
segment pores (double-pored tapeworm) - contains one set of reproductive organs

Gravid Proglottids Gravid Proglottid

- size and shape of the pumpkin seed and - dark, rosette-like, coiled uterus
are filled with capsules or packets of - disintegrate only when the segment has
about 8 to 15 eggs enclosed in an completed its reproductive function
embryonic membrane
- when detached, either migrate out of
Gravid Proglottids the anus or passed out with feces
- no testes and ovary - disintegrates in the environment and
 - uterus hollows out and filled with eggs
- separated from strobila and disintegrate
as they pass out of the intestines,
releasing eggs in the stool
S. name Hymenolepis nana (5)
C. name dwarf tapeworm
- spherical or subspherical measuring 30
to 47 um in diameter
- with six-hooked (hexacanth) oncosphere
- has a thin outer membrane and a thick
inner membrane with conspicuous bipolar
thickenings, from each of which arise 4 to
Egg 8 hairlike polar filaments embedded in the
inner membrane
- usually liberated from the gravid
segments before they become detached
- immediately infective when passed with
the stool and cannot survive more than 10
days in the external environment
Clinical - enteritis, diarrhea, abdominal pain,
Manife anorexia
station - majority asymptomatic
Diagno - demonstration of characteristic
sis embryonated eggs in stool
- proglottids generally not recovered
because they undergo degeneration prior
to passage with stools
-Eggs of Hymenolepis nana. These eggs
are oval and smaller than those of H.
diminuta, with a size range of 30 to 50
µm. On the inner membrane are two
Hymenolepis diminuta (6)
rat tapeworm
- circular, about 60 to 80 um in diameter
and are bile stained
- oncosphere is enclosed in an inner
membrane, which has bipolar thickenings
but lacks the bipolar filaments (absence of
polar filaments readily differentiates this
species from H. nana)
- hooklets have a fan-like arrangement
- minimal and non specific
- identification of eggs and scolex in stool
-Eggs of Hymenolepis diminuta. These
eggs are round or slightly oval, size 70 - 85
µm X 60 - 80 µm, with a striated outer
membrane and a thin inner membrane.
The space between the membranes is
smooth or faintly granular. The
oncosphere has six hooks. There are no
not in the intestines
Dipylidium caninum (7)
double-pored dog tapeworm (not in pdf)
- released by contraction of the proglottid
or by its disintegration outside the host
- spherical, thin-shelled with a hexacanth
embryo
- some may remain in the host’s resting
place and may be ingested by larval fleas
- minimal symptoms; gastrointestinal and
allergic reactions
- some asymptomatic
- pets may exhibit behavior to relieve anal
pruritis (such as scraping anal region
across grass or carpeting)
- most striking feature in animals and
children consists of the passage of
proglottids
- identification of scolex and proglottids
- egg capsules rarely recovered from stool
(stool exam not recommended)
Diphyllobothrium latum (8)
fish tapeworm or broad tapeworm
- unembryonated when laid
(approximately 1,000,000 per day); will
complete development in water
- yellowish brown, with a moderately thick
shell and an inconspicuous operculum (the
lid or caplike cover on certain
platyhelminth eggs)
- mean size : 66 x 44 um
- majority asymptomatic
- can cause vitamin B12 deficiency anemia
(vitamin B12 content of D. latum is
approximately 50 times that of T.
saginata)
-After the larva is ingested by a fish-eating
mammal, it hooks onto the small
intestine, where it grows to maturity,
freeloading on its host for nutrients (it has
a special affinity for Vitamin B12).
- finding of characteristic operculated
eggs, proglottids, scolex
- examination of gastric juice for the
presence of free HCl to differentiate
anemia due to diphyllobothriasis from
pernicious anemia
 poles, from which 4-8 polar filaments polar filaments extending into the space
spread out between the two membranes. between the oncosphere and the outer
The oncosphere has six hook shell.
Treatm
Praziquantel Praziquantel Praziquantel Praziquantel
ent
S. name Hymenolepis nana (5) Hymenolepis diminuta (6) Dipylidium caninum (7) Diphyllobothrium latum (8)

C. name dwarf tapeworm rat tapeworm double-pored dog tapeworm (not in pdf) fish tapeworm or broad tapeworm

- personal hygiene and environmental - personal hygiene and environmental - personal hygiene and environmental - thorough cooking of freshwater fish or
Preven
sanitation sanitation sanitation freezing for 24 to 48 hours at -18 ◦C;
tion
- rodent control - rodent control - periodic deworming of pet cats and dogs marinating will not
and
- proper storage of food - elimination of insect intermediate hosts - elimination of intermediate hosts (anti- - personal hygiene and environmental
Control
- thorough treatment of cases - protection of food flea treatment of pets) sanitation
Inf. Stg. Embryonated egg Cysticerci Cysticercoid Procercoid larvae
(see pic then read below)
FOR H. nana (see pic then read after) (no extra details in PDF for H. diminuta & D. caninum)
In addition, copepods may accidentally be
Intermediate Hosts
ingested by humans or other definitive
Arthropods, especially beetles, serve as intermediate hosts for Hymenolepis spp. The arthropod intermediate host is
hosts while drinking copepod-
required for H. diminuta, but not H. nana, and humans can become infected with the latter by direct ingestion of eggs. Within the
contaminated water. In those cases, the
Life arthropod host, the eggs develop into cysticercoids, which can infect the mammalian host upon ingestion and develop into adults in
plerocercoid may develop in the definitive
Cycle the small intestine.
or final host as a sparganum. The
Tribolium confusum, a common intermediate host for Hymenolepis spp. Tribolium and related genera breed in cereals,
condition in which plerocercoids or
grains, and grain-based snack foods and are easily ingested by humans and rodents. Since these food products are usually not
spargana develop in the definitive host is
heated prior to consumption, cysticercoids within the beetles remain viable and infective.
known as sparganosis. (referring to other
Diphyllobothrium spp.)
 Echinococcosis
Causal Agent
Human echinococcosis (hydatidosis, or hydatid disease) is caused by the larval stages of cestodes (tapeworms) of the genus Echinococcus.
Echinococcus granulosus causes cystic echinococcosis, the form most frequently encountered E. vogeli causes polycystic echinococcosis
E. multilocularis causes alveolar echinococcosis E. oligarthrus is an extremely rare cause of human echinococcosis
S.name Echinococcus granulosus (9)
C.name hydatid tapeworm
General Characteristics Diagnosis
- larval form in human tissue causes pathology - X-ray, ultrasound, CT
- human accidentally ingests eggs by close contact with infected dog; usual intermediate host - aspirate of “hydatid sand”
is sheep - serologic tests
Adult
- inhabits small intestines of canines Treatment
- 3 to 6 mm in length - Surgical resection (treatment of choice)
- pyriform scolex, short neck, and three proglottids (immature, mature, gravid) - Albendazole for inoperable cysts
- scolex is taeniid in that it has four acetabula
- armed with 30 to 36 hooks
Gravid Proglottid
Prevention and Control
- widest and longest proglottid
- Reduction of infected population
- uterus is midline with lateral evaginations and is filled with eggs which resemble those of
- Minimize opportunities for transmission
other taeniid worms
S.name Echinococcus granulosus (9)
C.name hydatid tapeworm
Egg Clinical Manifestation
- may be released inside or outside the host - pathology caused by developing larval cyst (liver is the most important site)
- contains a hexacanth embryo - local immunosuppression (able to escape host cell-mediated response)
- when swallowed by intermediate host, embryo released by the action of digestive juices, - enlarging cyst results in organ impairment as the neighboring tissues undergo atrophy and
bore actively into the intestinal wall and enter blood vessel tissue necrosis
-As dogs and other canids are the definitive hosts for Echinococcus spp., eggs are not - rupture of cyst : protoscolices, brood capsules, and daughter cysts may metastasize and
expected to be found in human stool and are not considered diagnostic in human infections. reach other tissues to develop into secondary cysts after 2 to 8 years (multiple organ
Eggs are however indistinguishable from the eggs of Taenia spp. and other members of the involvement)
Taeniidae. The eggs measure 30-35 µm in diameter and are radiallystriated. The internal - serious anaphylaxis may result from large amount of hydatid material entering the
oncosphere contains 6 refractile hooks. bloodstream when primary cyst ruptures
Hydatid Cyst
Life Cycle
- larval stage in the intermediate host (goat, horse, camel, sheep, human)
- Intermediate Host : sheep, goat, swine, cattle, horses, camel
- formed through central vesiculation
- unilocular hydatid cyst
- contains numerous protoscolices
- usually measure 1 to 7 cm in diameter
- has an outer laminated hyaline layer and an inner nucleated germinal layer
- vesicular structure formed by E. granulosus larvae in the intermediate host
- contains fluid, brood capsules, and also daughter cysts in which the scolices of potential
tapeworms are formed

Cross section of a hydatid cyst. Host tissue can be seen in the upper left corner, then the wall
of the cyst, the germinal layer and finally a daughter cyst, containing protoscoleces, floating
free in the fluid-filled interior.
Hydatid Sand
- granular material consisting of free scolices, hooklets, daughter cysts, and amorphous
material
- found in the fluid of older cysts of E. granulosus

S.name Echinococcus multilocularis (10) Echinococcus vogeli (11) Echinococcus oligarthus (12)
Gen - same life cycle as with E. granulosus except the hosts - same life cycle as with E. granulosus except the hosts - same life cycle as with E. granulosus except the hosts
Charac - foxes are the natural definitive host, and to a lesser
extent dogs, cats, coyotes and wolves; the intermediate - definitive hosts are bush dogs and dogs; the - up to 2.9 mm long
 host are small rodents
- 1.2 to 3.7 mm long Echinococcosis
- human infection through eating raw plants intermediate hosts are rodents; and the larval stage (in
contaminated with feces of infected canines or cats the liver, lungs and other organs) develops both
- most common site of alveolar hydatid cyst is the liver externally and internally, resulting in multiple vesicles - has a life cycle that involves wild felids as definitive
(hepatic lesions consisting of many alveoles that hosts and rodents as intermediate hosts
contained a gelatinous mass) - up to 5.6 mm long
- treatment : surgery or albendazole in inoperable cases
SEE PIC ABOVE FOR LIFE CYCLE BESIDE ECHINOCOCCOSIS
----------Sparganosis----------
Sparganosis is an infection by the plerocercoid larvae of various diphyllobothroid Sparganum infection occurs by three major routes:
tapeworms belonging to the genus Spirometra. It is similar in morphology and life cycle to the 1. drinking water contaminated with copepods infected with the procercoid larval stage of the
fish tapeworm, Diphyllobothrium latum. Sparganosis is reported sporadically around the world; parasite
a higher prevalence of the disease occurs in several Asian countries. 2. ingestion of undercooked meat, such as pork, that is infected with the plerocercoids
Sparganosis is infection by the third-stage plerocercoid larva (sparganum) of 3. placing poultices of frog or snake flesh on open wounds or other lesions, or the eyes
pseudophyllidean cestodes of the genera Spirometra. There are several species of Spirometra, Hosts & Vectors:
including S. mansoni, S. mansonoides, S. erinacei, S. ranarum, S. decipiens, S. houghtoni, S. Dogs and cats are the primary hosts of the adult worm. The first intermediate hosts are
proliferum. copepods, or freshwater crustaceans. The second intermediate hosts are amphibians, reptiles,
The larvae are often referred to by the generic name Sparganum, because this stage birds, and mammals.
was previously thought to represent a separate genus. Humans cannot serve as definitive hosts for Spirometra spp., but serve as paratenic or
Spargana can be found in many organs in the human host, including the pleural cavity, second intermediate hosts and develop sparganosis. Snakes and tadpoles/frogs are the vectors
eyes, pericardium, abdominal cavity and viscera, and the central nervous system. for sparganum.
The clinical manifestations of sparganosis depend on which organs or tissues are Prevention:
Diagnostic Tests:
involved. Subcutaneous tissues are most likely to be infected by the parasite, but visceral 1. drinking boiled or filtered water
1. Computed tomography (CT)
organs and the orbit of the eye, and rarely, the brain. 2. cooking possible intermediate and
2. Magnetic resonance imaging (MRI)
Ocular sparganosis - may result in blindness paratenic hosts thoroughly
3. Enzyme-linked immunosorbent assay
Cerebral sparganosis - characterized by seizures, fatigue, fever, confusion, headaches, 3. avoiding the practice of applying flesh of
(ELISA)
memory loss, and other CNS symptoms frogs to inflamed areas
Proliferative sparganosis - caused by S. proliferum, begins with a subcutaneous tumor Management and Therapy:
in the thigh, shoulder, or neck, and eventually spreads to other parts of the body 1. Surgical removal of sparganum larvae is usually curative
The early migratory stages in the development of the sparganum are asymptomatic, 2. Praziquantel (no effect on adult worms in the CNS)
but when it has reached its final site and begins to grow, its presence elicits a painful There is no available treatment for proliferative sparganosis. Attempts at surgical
inflammatory reaction in the surrounding tissues. removal of S. proliferum have been unsuccessful because of the widespread dissemination of
the larva.

----------Sparganosis----------
 Sparganum proliferum. Gross pictures of male patient showing multiple skin lesions The white plerocercoid seen in the subcutaneous tissue along the excision line (gross
which are mostly popular and nodular. Linear elevations suggest shape of the worm beneath findings). Moving speed of the larva, Sparganum mansoni, is slow, so that the larva can easily
the skin. Note gynecomastia. be found during biopsy procedure. (after eating meat of wild chicken)
Life Cycle