parasitology

Medical Parasites:
- Protozoa
- Helminthes:
- Arthropoda

1- Platyhelminthes
2- Nemathelminthes
3- Nematomorpha
4- Acanthocephala
5- Annelida

Classification of Helminthes
According to transmission methods
1- Soil transmitted Helminthes : Ascaris, Hook worms
2- Snail t. H. : Trematoda ( Schistosoma,.)
3- Arthropods t. H. : Fillaria, Dracanculus medinensis
4- Food and Meat t. H. : Taenia saginata, Taenia solium

5- Direct t. H. ( contagious H.): Enterobius vermicularis,

Platyhelminthes:
- Eucestoda

1- Cestoda( Tape-worms):
2- Trematoda

- Cestodaria

Eucestoda: ( Human Parasites);

Order: - Cyclophyllidea: Taenia spp. , Echinococcus
- Pseudophyllidea: Diphyllobothrium latum
-
-

Human pathogen Cestods

A- Ault forms of Cestoda( Definitive host): Taenia spp.
B- Larva stage of Cestoda( intermediate host): E. granulosus
General characters of Cestoda:
1- an anterior attachment organ( scolex);
- sucker( bothria, bothridia)

Cestode body :

- rostellum

2- neck region
3- a chain of segments( strobila):
- Immature proglottids
- Mature p.
- Gravid p.

Different Tracts of Cestoda

Digestive system; tegument play role of
absorption tract

Reproduction system :
all tapeworms of man are hermaphroditic
*male and female organs are found in mature proglottids.

Diphyllobothrium latum
Causal Agents:
The cestode Diphyllobothrium latum (the fish or
broad tapeworm), the largest human tapeworm.
Several other Diphyllobothrium species have been
reported to infect humans, but less frequently; they
include D. pacificum, D. cordatum, D. ursi, .

Section of an adult
D. latum containing many
proglottids

Scolex of D. latum

Proglottids of D. latum

Geographic Distribution
:
Diphyllobothriasis occurs in the Northern
Hemisphere (Europe, newly independent states of the former
Soviet Union [NIS], North America, Asia) and in Uganda and
Chile.

Freshwater fish infected with Diphyllobothrium sp. larva may

be transported to and consumed in geographic areas where
active transmission does not occur, resulting in human
diphyllobothriasis. For example, cases of D. latum infection
associated with consumption of imported fish have been
reported in Brazil.

Diphyllobothriosis

Clinical Features
Diphyllobothriasis can be a long-lasting infection
(decades).
Most infections are asymptomatic.
Manifestations may include abdominal discomfort,
diarrhea, vomiting, and weight loss.
Vitamin B12 deficiency with pernicious anemia may
occur.
Massive infections may result in intestinal obstruction.
Migration of proglottids can cause cholecystitis or
cholangitis.

Laboratory Diagnosis
Microscopic identification of eggs in the
stool is the basis of specific diagnosis.

Examination of proglottids passed in the

stool is also of diagnostic value.

Diagnostic findings
Microscopy

Carmine-stained proglottids of D.
latum, showing the rosette-shaped
ovaries

Taenia saginata
( beef tapeworm)
Geographical distribution
- infection is cosmopolitan

- Location in host:
- ileum of small intestine

- Morphology:
-

Scolex is pear-shaped with 4 prominent round sucker without rostellum

Size of worm is very long( usually about 5 meters, sometimes exceeding
20 meters)
Posses 1000-2000 proglottids.
Mature proglottid measures about 12mm wide and 10mm long.

T. Saginata adult worm

Taenia saginata
(Scolex and segments)

Taenia solium
( pork tapeworm)
Geographical distribution
-

infection is cosmopolitan in countries where pork is eaten raw or

undercooked.

- Location in host:
-

The scolex is embedded in the mucosa of the jejunum with the rest of the
tape extending through the ileum.

- Morphology:
-

Scolex is soliel-shaped with 4 large suckers and a conspicuous rostellum

with 2 rows of alternating large and small hooks(25-30 hooks).
Size of worm is long( 2-10 meters in length), with usually around 1000
proglottids.
Mature proglottids are roughly square (12 x 10 mm ).

Scoleces of Taenia saginata and

Taenia solium

Gravid proglottids of Taenia saginata (Figures D and E)

and Taenia solium (Figures F and G)

Life cycle of Taenia

Life cycle of T. solium

Clinical Manifestation
due to adult worm
Often the first and only sign of infection:
- Presence of active proglottids in the feces
- feeling of them crawling out through the anus.
there may be umbilical pain, nausea, weakness, loss
of weight, alteration of appetite and headache (possibly
caused by toxic products or are allergic reaction) .

Generalized allergic manifestations, such as urticaria

with pruritis ani or widespread pruritis, result.

Pathogenesis
Physical action of the scolex on the mucosa
Inflamation of the mucosa in the ileum
sometimes occurs.
Intestinal obstruction, perforation or
appendicitis have been reported.

Cysticercosis
( infection with the C. cellulosae)
Cerebral Cysticercosis:
*epilepsiform attacks, headache, visual and aural symptoms and ...

*Muscular Cysticercosis
Ocular Cysticercosis
Subcutaneous Cysticercosis

Cysticercus bovis

cysticercus

Subcutaneous cysticercosis

Cerebral cysticercosis

Muscular cysticercosis

Subcutaneous nodules

Laboratory diagnosios
Microscopic identification :
Detect of eggs and proglottids in feces is diagnostic for
taeniasis,( but is not possible during the first 3 months
following infection, prior to development of adult tapeworms).

Microscopic identification of gravid proglottids (or, more

rarely, examination of the scolex) allows species
determination.

Microscopy Findings

A, B: Taeniid eggs. The eggs of Taenia saginata and Taenia solium are
indistinguishable morphologically.
The eggs are rounded, diameter 31 to 43 m, with a thick radially striated brown
shell. Inside each shell is an embryonated oncosphere with 6 hooks.

Treatment
Niclosamide ( Yomesan); are given in a single
dose,2 g for adults, 1.5 g for children weighing
over 34 kg and 1 g for those weighing 11-34 kg .
Praziquntel administered in a single dose of 10
mg/kg body weight.

Prevention and control

Meat inspection ( include the heart, shoulder
muscle, tungue and )
Freezing meat at -15 for 3 days 0r by heating
thoroughly 56.
Treatment of patients.

Hymenolepis nana
(the dwarf tapeworm)

Geographical distribution

Location in host:
the adults are found in the lumen of the upper three-quarters of the ileum.
Morphology:
It is a very short tapeworm, measuring 15-40 mm and has approximately
200 proglottids.
Scolex :
retractible rostellum with a single row of 20-30 small hooks and 4 suckers.

Neck is long and slender.

Mature proglottids are broader than long with a single common genital
pore on one side of strobila.

H. nana( adult worm)

Life cycle of Hymenolepis

Mature proglottids, Cysticercoid and egg of

H. nana

Clinical Manifestations and

Pathogenesis

Hymenolepis nana infections are most often asymptomatic.

Heavy infections with H. nana( more than 2000 worms)
can cause weakness, loss of appetite, vomiting,
headaches, anorexia, abdominal pain, and diarrhea.
Eosinophilia of up to 15% occurs in about 7% of infected
persons.
Necrosis of the mucosa has been found in rats but has not
been proved to occur in man.

Hymenolepis diminuta life cycle

Laboratory Diagnosis
Eggs of Hymenolepis nana

Eggs of Hymenolepis diminuta

Treatment
Praziquantel* is the drug of choice( given in a
single oral dose of 25 mg/kg body weight).
Niclosamide must be given daily for 5 days

 Dipylidium caninum (the double-pored dog

tapeworm) mainly infects dogs and cats,
but is occasionally found in humans.

Adult tapeworm of Dipylidium caninum

adults measure 10-70 cm long

Life
Cycle

Dipylidium Caninum

Trichodectes
Intermediate host of Dipylidium caninum

Geographic Distribution
Worldwide. Human infections have been
reported in Europe, the Philippines, China,
Japan, Argentina, and the United States.

Clinical Features
Most infections with Dipylidium caninum are asymptomatic.
Pets may exhibit behavior to relieve anal pruritis (such as
scraping anal region across grass or carpeting).
Mild gastrointestinal disturbances, and the passage of proglottids.
These can be found in the perianal region, in the feces, on diapers,
and occasionally on floor covering and furniture.
The proglottids are motile when freshly passed and may be
mistaken for maggots or fly larvae.

Laboratory Diagnosis
The diagnosis is made by demonstrating the
typical proglottids or egg packets in the stool
or the environment.
Diagnostic findings:
Microscopy
Macroscopy

C: D. caninum proglottid under a dissecting

microscope cleared with lactophenol.
D: D. caninum proglottid partially cleared with
lactophenol, showing eggs and egg packets.

Microscopy
Eggs
A: D. caninum egg packet, containing 8 visible eggs
B: D. caninum eggs clumped together

Treatment
Treatment for both animals and humans is
simple and very effective.
Praziquantel is given either orally or by
injection (pets only).
The medication causes the tapeworm to dissolve within the
intestines. Since the worm is usually digested before it passes,
it may not be visible in the dog's stool. These drugs are
generally well tolerated.