CESTODES Taenia saginata

- aka. beef tapeworm

Cestodes (Tapeworm) - transmitted from cows/cattle to man
-include multiple species of flatworms that can reside - Habitat: SI
in the human gastrointestinal tract (GI). - IH: Cattle
 Taenia saginata - DH: Humans
 Taenia solium - IS: Cysticercus bovis (2 months)
 Hymenolepis nana - DS: Egg or gravid proglottids
 Hymenolepis diminuta - MOT: Ingestion of raw or undercooked infected
 Dipylidium caninum meat
 Diphyllobothrium latum - Treatment: Praziquantel
 Echinococcus granulosus
Morphology:
Order Egg: hexacanth, spherical in shape, Egg has a thick
Pseudophyllidea – D. latum striated wall; brownish in color
Cyclophyllidea Scolex: Cuboidal, w/ 4 acetabula/suckers, no
hooklets and no rostellum
a.Species which requires a vertebrate intermediate Mature segment w/ ovary & testes.
host Gravid segment has 15 or more uterine branches.
b.Species which requires invertebrate intermediate
host
c. Species which may or may not require an
intermediate host

General Characteristics
- Flat, segmented, ribbon like bodies, are
whitish/creamy and yellowish in color and are
bilateral symmetrical.
- Are Hermaphroditic –
- Do not have a digestive tract
- they can be heteroxenous (more than one host is
parasitized) and homoxenous (only one host is
parasitized) as to host requirement
- Adult tapeworms are found in SI while larva stage
is encysted in tissues of Intermediate host.

Parts of the Tapeworm Body

1.Scolex – organ for attachment
2.Neck – region of growth
3.Segments/Proglottids – 3 types: immature, mature
and gravid/ripe

Pathogenesis and Clinical Manifestations

- Taeniasis – the passage of proglottids or segments
in the stool.
- mild irritation at the site of attachment
Taenia solium
- aka. pork tapeworm
- Habitat: SI
- IH: Man, Pig
- DH: Human
- IS: embryonated egg/cysticercus cellulosae
- DS: Egg or gravid proglottids
- MOT: Fecal – route / Ingestion of raw or
undercooked infected meat (measly pork)

Morphology:
Egg: hexacanth, more spherical than T. saginata, has
rostellum w/ 25-30 hooklets (2 rows)
Strobila/Proglottid: 7 to 15 branches
(dendritic/fingerlike)
Mature segment w/ ovary & testes & an accessory
lobe in the ovary
Gravid segment has 13 or less uterine branches w/
genital pore

Differences T. Saginata T. solium

CN: beef tapeworm pork tapeworm
IH: Cattle Pig / Man
w/ rostellar hooks
None, no warmed w/ 2 rows
Scolex
rostellar hooks of large and small
hooklets
Length 25 m 7m
# of
1000-2000 <1000
proglottids
15-20 lateral 7-13 lateral
Gravid
branches (tree branches
proglottids
like) (fingerlike)
Sperical, striated inside an embryo w/ 6
Eggs
hooklets
Larva
Cysticercus
Infective Cysticercus bovis
cellulosae
Stage
Taeniasis Taeniasis solium,
Pathogenesis
saginata cysticercosis
INFECTIVE STAGES
1. T. solium = cysticercus cellulosae.
2. T. saginata = cysticercus bovis.
 Cysticercus contains the larva of the adult taenia &
it is usually lodged in the skeletal muscles of the
pork or beef.
 Ingested cysticercus is acted upon by the gastric
juices & the scolex inside the cysticercus evaginates.
 The scolex or head then attaches to the walls of the
SI & begin to grow segments.
 Within 3 months, the taenia is fully grown with
immature, mature, & gravid segments.
 The gravid segments contain thousands of eggs &
these segments normally separate from the main
body.
 Once separated, these gravid segments are capable
of amoeboid movement where they move on their
own & can pass thru the anus of the host.
 These segments will then reach the outside
environment where the eggs will get into the IH
(cattle & swine) which feed on grass, food, or water
contaminated with excreta.
 Eggs inside the IH will hatch & develop into
cysticercus/cysticerci in the muscles & other organs.
 Cysticercosis is now the infection with the larval
form of taenia which is common among the animal
IH.
CONSEQUENCES OF TAENIASIS
 Most taeniasis cases are asymptomatic because
most infections are single-worm infections making
the symptoms vague & nonspecific if at all present.
 Most common complaint is the passing out of gravid
segments.
 Acute appendicitis if the segment is trapped in the
appendiceal
 lumen.
 Acute pancreatitis if the segment blocks the duct of
Wirsung.
 Cysticercosis with common sites in the skeletal
muscles, lungs, liver, & brain (neurocysticercosis).
PREVENTION AND CONTROL
1. Treatment of identified cases.
2. Proper excreta disposal.
3. Proper care of cows & pigs.
4. Screening of “measly pork” or “cysticerci-laden
beef” in slaughterhouses.
5. Proper cooking of pork or beef (560C is enough to
kill cysticercus).
6. Deep freezing of meat (-50C or lower definitely kills
infective stages).
7. Health education.
TREATMENT
1. Praziquantel = drug of choice.
2. Bithionol
 Expel the worms completely & get rid of the source
of eggs & gravid segments.
 Objective of treatment is not only to expel the
segments or proglottids but more importantly, to
remove the scolex of taenia.
LABORATORY DIAGNOSIS OF TAENIASIS
1. Feces
2. Perianal region (Cellophane Scotch
Tape)
a. Eggs
b. Structure of proglottids
Hymenolepis nana
- aka. dwarf tapeworm
- HOMOXENOUS
- cyclophyllidean tapeworm; the smallest tapeworm
- Only tapeworm to complete its entire life cycle in a
single host
- Eggs are infective when passed with stool, but
cannot survive more than about 10 days outside the
body.
- Habitat: SI DH: Humans, mice, rats
- IS and DS: Eggs (embryonated)
- MOT: Ingestion of embryonated egg from
contaminated food, water, or hands
- Treatment: Praziquantel, Nitazoxanide (alternative)
Morphology:
Egg: has bipolar thickenings and polar filaments;
spherical/subspherical, colorless/clay-colored
Scolex: Retractable rostellum w/ 20-30 Y shaped
hooklets
Strobila: 175 to 220 segments, 3 testes and 1 ovary
Hymenolepis diminuta
- aka. rat tapeworm
- requires IH
- can cause hymenolepiasis
- Habitat: SI
- IH: fleas, beetles, cockroaches, mealworms, earwigs
- DH: Humans, mice, rats
- IS: Cysticerci / cysticercoid larvae
- DS: Eggs / proglottids
- MOT: Ingestion of cysticerci in body cavity of insect
- Treatment: Praziquantel

Morphology: Non-operculated w/ embryo

Egg: circular, bile stained, fan like arrangement of
hooks, presences of bipolar thickening, NO POLAR
FILAMENTS and w/ intralaminal layers
Scolex: unarmed rostellum
Strobila: unilateral genital pores (larger than H.
nana)
Dipylidium caninum
- aka. flea tapeworm / cucumber tapeworm / double-
pored tapeworm
- very common intestinal parasite of dogs and cats
worldwide
- Dipylidiasis in humans is accidental and more
common in children than in adults
- Habitat: SI
- IH: Ctenocephalides canis, Ctenocephalides felis,
Trichodectes canis, Pulex irritans
- DH: Dog and cats
- IS: Cercocystis / cysticercoid larva
- DS: Proglottids
- MOT: Ingestion of fleas containing cysticercoid /
infected flea
- Treatment: Praziquantel
Morphology:
Egg: found in packets/embryonic membrane (8-15
eggs)
Scolex: globular, has 4 suckers and potrusible
rostellum, rose thorn shaped hooks
Strobila: pumpkin seed shaped enclosing egg
packets, melon seed/rice grain shaped (mature and
gravid)
Diphyllobothrium latum
- aka. fish tapeworm / broad tapeworm
- Diphyllobothriasis - the intestinal infection w/ adult
worm
- causes tapeworm anemia, hyperchromic,
megaloblastic anemia
- Habitat: SI
- IH: 1st – copepods (cyclops); 2nd – fresh water fish
(salmon), perch, trout, salmon, pike
- DH: Human, dog and cats, fish-eating mammals,
birds
- PH: Carnivorous fish
- IS: Plerocercoid larva
- DS: Unembryonated egg
- MOT: Ingestion of raw or undercooked infected fish
- Treatment: Praziquantel
Morphology:
Egg: yellowish brown, thick shell, operculated,
opposite is small knob like opening
Scolex: spatulate/spoon shaped/almond shaped w/
2 bothria/sucking grooves
Strobila: longer width than its length, presence of
dark, rosette like coiled uterus
Larval stages: coracidium > procercoid >
plerocercoid
Echinococcus granulosus
- aka. hydatid worm / hyper tapeworm / dog
tapeworm
- causes Echinococcosis; hydatid disease; hydatid cyst
- Habitat: SI
- IH: Sheep, goat, swine
- DH: dog, wolves, jackals, coyotes, foxes
- AH: Man
- IS: Embryonated egg
- DS: Hydatid cyst
- MOT: Ingestion of dog/canine stools filled w/
embryonated eggs
- Treatment:
 Surgical resection
 Albendazole
 Mebendazole
 Percutaneous aspiration, injection,
reaspiration (PAIR) technique

Morphology:
Egg: resembles Taenia specie
Hydatic cyst: outer laminated hyaline layer and
inner germinal layer
Scolex: armed scolex, 30-36 hooks and 4 acetabula
Strobila: widest proglottid
RECALLS:
A. Scolex/Head
1.With spatulate/spoon shaped/almond shaped
scolex
2.With globular scolex without hooks
3.With globular scolex with hooks
4.With Y-shaped hooks

B. Segments/Proglottids
1.With 3rd ovary (Accessory Ovarian lobe)
2.With Bilateral Genital Pores

C. Gravid/Ripe proglottid
1.Broader than long with rosette uterus
2.Elongated uterus with lateral uterine branches,
longer than broad and has cylindrical trunks (8
to 12/15 branches)
3.Elongated uterus with lateral uterine branches,
longer than broad and has cylindrical trunks (15
to 30 branches)
4.Broader than long, sac-like or saccular uterus
5.Longer than broad and loosely twisted uterus
6.Vase shaped or pumpkin seed shaped segments

1.Longest cestode as to length

2.Shortest as to length
3.Shortest cestode that can infect man in its adult
stage
4.Causes Vit.B12 deficiency anemia
5.Ingestion of Plerocercoid
6.Ingestion of Procercoid
7.Ingestion of Cysticercus larva
8.Ingestion of T.solium eggs only