CESTODES

Ta e n i a s o l i u m

Ta e n i a s a g i n a t a

Diphyllobotrium
latum

Hymenolepis nana

Hymenolepis
diminuta

Raillietina garrisoni

Dipylidium caninum

Echinococcus
granulosus

Echinococcus
multilocularis
 CESTODES

1 . Intestinal
Diphyllobothrium latum
Dipylidium caninum
Hymenolepis nana
Hymenolepis diminuta
Taenia saginata
Taenia solium
2. Tissue
Echinococcus granulosus
Echinococcus multilocularis
Spirometria mansonoides
 GENERAL CHARACTERISTICS AND
CLASSIFICATION
Adult
White and yellowish in color
Long, tape-like multi-segmented worms flattened
dorsoventrally (flat and ribbon like in appearance)
Found in the small intestine of man
No circulatory system and is usually divided into segments or
proglottids
No digestive system
Nervous system is confined primarily in the scolex
Excretory system consists of flame cells, capillaries and
collecting tubules
Reproductive system consists of both male and female which
are both present in each segment (monoecious)
 GENERAL CHARACTERISTICS AND
CLASSIFICATION
Three par ts/regions of adult tapeworm
Scolex
Head
For attachment (holdfast organ)
Accessory structures present that will help in the attachment
2 sucking grooves/sulci
4 cup-like suckers (in some species)
Rostellum
Hooklets
Neck
Region of growth
Strobila
Chain of proglottids or segments
 GENERAL CHARACTERISTICS AND
CLASSIFICATION
Three types of segments
Immature segment
Present near the neck. The male and female sex organs are still
immature and are not differentiated
Mature segment
Large segment. Male and female sex organs are differentiated
Each segment contains single, sometime two sets of male and
female genital organs
Gravid segment
Situated farthest away from the scolex
Uterus is completely filled up with eggs
 GENERAL CHARACTERISTICS AND
CLASSIFICATION
Life Cycle
1 . The Egg
The egg with a hexacanth embryo or oncosphere

2. The Larval Stage

Coracidium, Procercoid, Plerocercoid, Cysticercoid, and Cysticercus
larvae
3. Adult Stage
 THE LARVAL STAGE

Lar val stages

Solid type
Plerocercus/procercoid/procercus
Present in the 1 st IH
Relatively globular with the scolex invaginated into the body
Plerocercoid/sparganum larva
Present in the 2 nd IH
Elongated with head free or invaginated only in the neck
Cystic type
Cysticercoid
Larva is provided with a slightly developed bladder anteriorly, into which the
head is invaginated and with an elongated solid posterior portion
2. Cysticercus (true bladder worm)
In this type of larva, head is invaginated into the proximal portion of the
bladder
Simple, Coenurus, Echinococcus/Hydatid
CLASS CESTOIDEA
Order Pseudophillidea
Scolex typically unarmed, with a dorsal and ventral grooves ( bothria)
All representatives in man belong to Superfamily Bothriocephaloidea
Order Cyclophillidea
Scolex with 4 suckers and usually a centrally placed apical
rostellum, frequently armed with hooks
All species found in man belong to Superfamily Taeniodea
 Bases for Order Pseudophyllidea Order
differentiation Cyclophillidea
Shape of scolex Spatulate/almond Vary (globular, quadrate)
Accessory organ in 2 sucking grooves 4 suckers (some with
scolex (bothria/sulci) rostellum, hooklets)
Appearance of uterus Rosette (highly coiled Vary (some with uterine
uterus) branches, succular)
Eggs/ova Ovoidal, operculated, Spherical, mature
immature
Embryo Coracidium ciliated Oncosphere with three
pairs of hooklets
Larval stage Solid (a) plerocercoid Cystic
(b) procercus
Ways of releasing eggs Via uterine pore Apolysis
in gravid segment
Number of 2 1
intermediate hosts
utilized
 MEDICALLY IMPORTANT SPECIES OF
TAPEWORMS
Or der Pseudoph illidea
Diphyllobothrium latum
Or der C yc loph illidea
A . Species which require ver tebrate IH
Taenia solium
Taenia saginata
B. Species which require inver tebrate IH
Dipylidium caninum
Hymenolepis diminuta
Raillietina garisoni
C. Species which may or may not require IH
Hymenolepis nana
D. Species which may infect man in their lar val stage
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Spirometra mansoni
 Taenia solium

Common name: Pork tapeworm

Diseases: Pork tapeworm infection, Taeniasis solium,
Cysticercosis
The life cycle of the parasite was first described by Van
Beneden. He demonstrated the larval stage in the muscle of
pig after feeding it with eggs from the human feces
It is the only cestode for which man acts as both definitive
and intermediate host
Habitat: Small intestine usually the jejunum
 Taenia solium

MORPHOLOGY
Adult worm:
The head or the scolex is globular in shape with 4 cup-shaped
suckers.
The scolex is provided with the rostellum with a double row of
hooklets.
The neck is short, measuring 5 to 10 mm in length.
The number of proglottids or segments is about 800 to 1000
The common genital pore is marginal
The gravid uterus consists of a median stem with 5 to 13 lateral
uterine branches on each side.
Each gravid segment consists of 30,000 to 50,000 eggs.
 Taenia solium

Egg:
The eggs is spherical, brown, and measures 31 to 56 um in diameter.
It has two radially striated shells.
The outer shell is thin and rarely seen.
The inner shell is brown, thick and striated
Inside is an embryo or an oncosphere with 6 hooklets

Larval Stage:
The larval stage or baldder worm is called cysticercus cellulosae.
There is a dense milky white spot at one side where the invagnated
scolex with hooks and suckers is located.
 Taenia solium

LIFE CYCLE
The adult worm attaches to the mucosa of the small intestines by
means of the scolex.
Gravid segments can either detach by apolysis and move out of the
anus or be discharged with the feces.
Pigs ingest gravid segments or eggs while feeding on human feces,
and cysticercosis develops in pigs muscles and other tissues.
The infected meat is termed measly pork
Man may accidentally ingest eggs thus giving rise to cysticercosis or
he may ingest raw or insufficiently cooked pork containing cysticerci,
resulting in taeniasis solium.
The scolex evaginates and attaches itself to the intestinal mucosa as
the bladder portion disintegrates
The worm starts to produce segments and reaches maturity in 2 to 3
months.
 Taenia solium

Infective Form
Cysticercus cellulosae
also known as Taenia cyst
small, oval, and fluid-filled milky white bladder-like structure

Pathology And Pathogenesis

Both adult and cysts are pathogenic
Adult worms are less pathogenic, occasionally may cause mild
irritation or inflammation of the intestinal mucosa by their armed
scolex
Cysts are more pathogenic, most cysts are produced in the skin,
skeletal muscle, eye and in the CNS
 Taenia solium

Clinical Manifestation
Intestinal taeniasis
Cysticercosis
Muscular and subcutaneous cysticercosis
Occular cycticercosis
Neurocycticercosis

Reser voir, source and t r ansmission of infection

Both human and pigs are the reser voirs of infection

Intestinal Taeniasis
Cyst is the infective stage
Raw or undercooked pork infected with the cyst is the source of infection
Cysticercosis
Egg is the infective stage
Human feces are the chief source of infection
 Taenia solium

Man acquires cycticercosis by:

Ingestion of food and water contaminated by the eggs present
in the feces
Anus-hand-mouth transfer of the eggs by contaminated hands
of person with poor personal hygiene (endogenous auto
infection)
Internal autoinfection by the regurgitation of eggs into the
stomach by reverse peristalsis

Diagnosis
Stool examination or scotch tape and anal swab may reveal
characteristic eggs of Taenia
Slide compression technique for gravid segment and the
number of uterine branches are counted
 Taenia solium

Other tests:
Serodiagnosis (ELISA, EITC)
Histopathological diagnosis
Imaging methods (X-ray, CT scan, MRI)
Elevated CSF protein
Mild to moderate low glucose level
CSF lymphocytosis, mononuclear pleocytosis

Criteria for cure:

Recovery of scolex
Negative stool exam 3 months after treatment
 Taenia saginata

Taeniasis saginata refer s to the infection of man with the adult beef
tapeworm.
Man gets the infection by eating raw or insuf ficiently cooked beef
containing the cysticercus .
There is no cysticercossi due to T. saginata in man.
Recently, a third human tapeworm was shown to be distributed in the
Asian-Pacifi c region: Korea, Indonesia, Philippines, and Thailand. It is now
generally referred to as the Asian Taenia.
DNA studies showed that the Asian Taenia is closely related to T. saginata.
The Asian Taenia infects cattle, goats, monkeys and wild boar s, but pigs
are the dominant intermediate hosts.
Common name: Beef tapeworm
Diseases: Taeniasis saginata, Beef tapeworm infection
Most common large tapeworm of human causing intestinal taeniasis
Acquired orally by ingesting beef infected with the lar vae
The cattle were demonstrated to be an intermediate host by Leuckar t in
1 863
Habitat: Small intestine par ticularly the upper jejunum. They remain
attached to the intestinal mucosa with their sucker s
 Taenia saginata

MORPHOLOGY
Adult:
Whitish opaque in color
The worm is attached to the mucosa of the small intestines by means
of the scolex
The scolex is similar to that of T. solium except for the absence of
rostellum, spines or hooklets.
There are more segments in T. saginata than in T. solium, there being
1,000 to 2,000 segments in T. saginata.
The lateral uterine branches of the uterus in the gravid segments
number 15 or more.
 Taenia saginata

Eggs:
Each proglottid may contain about 80,000 eggs.
T. saginata eggs are indistinguishable from T. solium eggs.

Larval Stage:
Cysticercus bovis or the larval stage of T. saginata is similar to
cysticercus cellulosae except that the scolex is unarmed.
Cysticercus larvae may remain viable in the tissue of cattle for about
8 months.
 Taenia saginata

LIFE CYCLE
The life cycle is similar to that of T. solium except that the
main intermediate hosts are cattle, carabao, and goats,
instead of pigs.
Cattle gets infected when T. saginata eggs on blades of grass
are ingested in the grazing field.
Cysticercosis develops in the muscle of the cattle.
Man is infected when beef is eaten raw or insuf ficiently
cooked.
It takes about 2 to 3 months for a cysticercus or bladder
worm ingested with raw beef to grow into an adult.
Like the pork tapeworm, it inhabits the small intestine.
 Taenia saginata

Infective form
Cysticercus bovis
Oval, translucent cyst filled with a clear fluid. It contains an
opaque invaginated protoscolex (future scolex)
This stage is not found in human

Pathology And Pathogenesis

Adult worm is non-pathogenic
 Taenia saginata

Clinical Manifestation
Taenia saginata causes intestinal taeniasis but does not
cause cysticercosis in human

Intestinal Taeniasis
In symptomatic cases, the clinical manifestations are non -
specific and mild. These include nausea, abdominal
discomfort, hunger pain, loss of weight, chronic ingestion
Abdominal pain and nausea are more common in morning.
The proglottids crawl around the anus during day time
Complications Intestinal obstruction, appendicitis and
pancreatitis
 Taenia saginata

Reser voir, source and transmission of infection

Man is the only reservoir of infection
Contamination of the environment by human feces is the most
crucial in maintaining the infection in the community
Raw or undercooked beef containing Cysticercus bovis is the
source of infection for human

Man acquires infection by:

Eating raw or undercooked beef harboring the cysticerci
Tasting meat dishes during cooking
 Morphological Taenia solium Taenia saginata
Differences

Adult Length 2-7 meters 5-10 meters

Adult - # of 800-1,000 1,000-2,000

segments
Scolex shape Globular Quadrte

Scolex - # of suckers 4 4

Scolex - Rostellum Present Absent

Scolex Hooklets Present, double row of 20-25 Absent

Mature segment - Tubular uterus - 1 ovary with 2 large ovarian

- 1 ovary with 2 large ovarian lobes
lobes and 1 accessory - wider than long
- wider than long

Gravid segment - 150-200 testicular follicle - 330-400 testicular follicle

- 5-14 uterine branches - 15-20 uterine branches
- Longer than broad - Longer than broad
 Morphological Taenia solium Taenia saginata
Differences

Infective stage Cysticercus cellulosae Cysticercus bovis

Intermediate Hogs, pigs Cattle cow

hosts
Eggs Spherical, non-operculated, Same as T. solium
mature with 3 pairs of hooklet
and shell striation. Walnut
brown
 Diphyllobothrium latum

Diphyllobothriasis or fish tapeworm infection is acquired

through the ingestion of raw or inadequately cooked fish with
the pleroceroid larva.
Other fish-eating mammals of the dog and cat families
become infected by eating freshwater and brackish water
species of fish.
Infection with the procercoid larvae results in human
sparganosis.
Common name: Broad or Fish Tapeworm
Disease: Diphyllobothriasis, bothriocephaliasis,
Dibothriocephalus anemia, fish tapeworm infection
Habitat: Small intestine mainly the ileum and jejunum
 Diphyllobothrium latum

MORPHOLOGY
Adult:
Diphyllobothrium latum is a Pseudophillydean tapeworm
characterized by an unarmed scolex with a dorsal and ventral sucking
organ called bothrium.
The adult worm is ivory white and has 3,000 proglottids
The scolex is spoon shaped or spatulate with a pair of deep sulci.
Mature proglottids are broader than they are long and contain fully
developed male and female reproductive organs.
The characteristic feature is the uterus which appear in rosette
formation and opens to the uterine pore situated on the ventral side
of the segment.
 Diphyllobothrium latum

Eggs:
Broadly ovoidal, operculated , moderately thick shelled and light
golden yellow in color
The coracidium that is liberated from the egg shell is ciliated and
swims freely in water.
The procercoid lar va has 3 pair s of hooklets in the cercomer.
The plerocercoid lar va or sparganum is glistening opaque white, it
has an invaginated anterior end, but has no scolex and is
unsegmented
 Diphyllobothrium latum

L I F E C YC L E
T h e a d u l t t a p ew o r m i s m o s t f r e q u e n t ly a t t a c h e d to t h e i l e um o f t h e s m a l l i n te s t i n e s
o f m a n a n d o t h e r a n i m a l s.
E g g s a r e ev a c ua te d p e r i o d ic a l ly t h r o ug h t h e u te r i n e p o r e .
A s m a ny a s 1 , 0 0 e g g s p e r d ay a r e p a s s e d o u t i n t h e f e c e s . T h ey a r e i m m a t ur e w h e n
o v i p o s i te d .
U p o n r e a c h i n g a b o d y o f f r e s h w a te r, t h e e g g m a t u r e s a n d l i b e r a te s t h e c i l i a te d
c o r ac i i um i n 1 1 to 1 5 d ay s .
T h e f r e e - s w i mm i n g c o r a c id i um m u s t b e i n g e s te d b y t h e a p p r o p r ia te i n te r m e d ia te
h o s t w i t hi n 1 2 h o u r s .
T h e f i r s t i n te r m e d ia te h o s t s a r e t h e c o p e p o d s ( D i a p to m us a n d C yc l o p s ) .
I n t h e c o p e p o d , t h e c o r a c i d ium i s t r a n s f o r m ed i n to a p r o c e rc o i d l a r v a i n 2 to 3
weeks.
I f c o p e p o d s a r e i n g e s te d b y f r e s h wa te r f i s h , t h e p r o c e rc o id l a r v a d ev e l o p s i n to a
p l e r o c e rc o id a l r v a w h i c h l i e s f r e e b et w e e n t h e m u s c l e f i b e r s .
T h e s p a r g a n a a r e t r a n s fe r r e d to l a r g e r e d i b l e f i s h w h e n t h e s e f i s h d ev o ur s m a l l e r
i n f e c ted f i s h .
D i f fe r e n t t y p e s o f f r e s h wa te r f i s h t h e r e f o r e s e r v e a s t h e s e c o n d i n te r m e dia te h o s t s .
W h e n r aw o r i n s u f fi c i en t l y c o o ke d f i s h i s e a te n , t h e l a r v a a t t a c h e s to t h e i n te s t i n a l
wall.
I t t a ke s 3 to 6 w e e k s a f te r e a t i n g r aw o r i n s u f fi c ie n t l y c o o ke d f l e s h o f i n f e c te d f i s h
b e f o r e e g g s b e g i n to a p p e a r i n t h e f e c e s o f m a n .
 Diphyllobothrium latum

Definitive host
Man
Intermediate hosts
First IH:
Fresh water copepods
Diaptomus gracilis
Diaptomus graciloides
Cyclops furcifer
Cyclops strennus
Second IH:
Fresh water large predatory fishes
 Diphyllobothrium latum

Pathogenesis And Pathology

D. latum infection is associated with hyperchromic megaloblastic anemia
with thrombocytopenia and leukopenia. The following factor s contribute to
the pathogenesis of anemia:
The adult worm has extra -ordinar y af finity for vitamin B1 2 in the stomach
Low dietar y intake of vit. B1 2
Reduced secretions of intrinsic factor s
Since vit. B1 2 is essential for the development of er ythrocytes, the
deficiency of it causes pernicious or tapeworm anemia

Reser voir, sourc e and tr ansmission of infec tion

Man is the oppor tunisti c and reser voir of infection and is transmitted
orally by:
Consuming raw, smoked, lightly salted or insuf ficiently cooked fish
Eating liver of the fish raw

Diagnosis
Demonstrati on of eggs in feces, sometimes chains of proglottids in feces
Coproantigen detection test
 Hymenolepis nana

This is a very small tapeworm more often among mice and less
frequently among rats.
It is commonly called the dwarf tapeworm.
In man, the dwarf tapeworm produces an intestinal infection
called hymenolepiasis nana.
This is the only human tapeworm without an obligatory
intermediate host.
Common name: Dwarf tapeworm
Disease: Hymenolepsiasis nana
Common parasite of man.
One of the smallest cestode that parasitizes man.
The only cestode that can complete its life cycle even without
intermediate host
Habitat: Resides in the ileal portion of the small intestine of
man, and also of rats and mouse.
 Hymenolepis nana

MORPHOLOGY
Adult:
The scolex is subglobular with the four cup-shaped suckers.
There is a well-developed rostellum armed with a single row of 20 to 30
Yshaped hooklets.
The neck is long, the anterior proglottids are short and the posterior ones
are broader than long.
The genital pores are unilateral.
Mature proglottids are characterized by the presence of three ovoid
testes and one ovary in a more or less straight pattern across the
segment.

Eggs:
Spherical or subspherical and contains an oncosphere.
It has an outer membrane which measures 40 to 60 um and an inner
membrane with conspicuous bipolar thickenings from each of which
arise 4 to 8 filaments.
 Hymenolepis nana

LIFE CYCLE
This tapeworm dif fer from other cestodes in that it can follow either a
direct cycle, whre it does not require an intermediate host, or an
indirect cycle, where an intermediate host is obligator y.
In the direct cycle, eggs can initiate an infection readily when ingested
by a definite host like man, mouse or rat. The eggs hatch in the
duodenum and liberated embr yos penetrate the nearby villi and then
develop into cysticercoid lar vae. Once the cysticercoid lar vae mature,
they penetrate the intestinal lumen, attach to the mucosa and develop
into adult worms.
The indirect cycle utilizes some ar thropod intermediate hosts which
include the rat flea ( Xenopsylla cheopis), dog flea ( Ctenophalides
canis), human flea ( Pulex irritans), rice and flour beetles ( Tenebrio sp.)
and cockroaches ( B. germanica). If the eggs are ingested by the lar val
fleas, adult beetles or cockroaches, the embr yos will develop into
cysticercoid lar vae in the body cavity of the ar thropods. When the
infected ar thropods are accidentally ingested by the final hosts, like
man, mouse or rat, the cysticercoid lar vae are released and eventually
develop into adult tapeworms in the intestines.
 Hymenolepis nana

T hree phases in t he Life Cycle of H. nana

1. Direct phase
Does not require intermediate host, only definitive host
2. Indirect phase
Ex. H. nana var. fraterna
Ova in beatles and fleas which may serve as IH. Ova becomes cysticercoid
3. Internal and external autoinfection
Internal eggs hatch out in the lumen of SI and liberate embryo which directly
invade the intestinal villi. Responsible in the increase of worm load in the SI
External person ingests ones own eggs by fecal -oral route due to bad personal
hygiene. Responsible for persistence of infection in the host

Intermediate Hosts:
Ctenocephalides canis
Pulex irritans
Xenopsylla cheopis
Tenebrio molitor
Tenebrio confusum
 Hymenolepis nana

P a t h o g e n e s is A n d P a t h o l o g y
D ev e l o p me n t o f c yc t ic e rc o i d l a r v a e i n t h e i n te s t i n e o f m a n c a u s e s l i t t l e o r n o
pathology
I n h e av y i n f e c t io n s , l a r g e n u m b e r o f w o r m s m ay c a u s e :
Mechanical irritation of the intestine
Various allergic manifestation such as anal and nasal pruritus by releasing toxic metabolites

R e s er v o ir, s o u rc e a n d t r a n s m is s io n o f i n f e c t io n
I n f e c te d h u m a n a r e t h e c h i e f s o u rc e o f i n f e c t io n
M a n i s t h e m a i n r e s e r vo i r
H ex a c a n t h e g g s a r e i n f e c t i ve to h u m a n
Tr a n s m i s s i o n o f i n f e c t i o n i n m a n o c c ur s :
1 . Fe c a l - o r al r o u te
2 . C o n t am i n a t i o n o f f o o d s a n d w a te r
3 . I n g e s t i o n o f f o o d s c o n t a m i n a te d w i t h f l e a s

D i a g n o s is
S to o l ex a m i n a t i o n r ev e a l s t h e c h a r a c te r is t i c e g g s w i t h i t s s i x h o o k l et s e m b r yo a n d
p o l a r f i l am e n t s
 Hymenolepis diminuta

This tapeworm is common among rats, hence it is also known

as the rat tapeworm.
Man may be accidentally infected, in which case an intestinal
condition called hymenolepiasis diminuta results.
Common name: Rat tapeworm
Disease: Hymenolepsiasis diminuta
Relatively large and a common parasite of mice and rats
It causes occasional infection in humans
 Hymenolepis diminuta

MORPHOLOGY
Adult:
The adult tapeworm is longer than H. nana.
The scolex is small, rounded, with four cup-shaped suckers.
There is a rudimentary and unarmed rostellum.
Mature proglottids of H. diminuta are similar to H. nana except in
size.
Gravid proglottids contain sac-like uterus filled with eggs.

Eggs:
Circular
Yellowish-brown in color
The oncosphere is enclosed in an inner membrane which has bipolar
thickenings but lacks polar filaments
 Hymenolepis diminuta

LIFE CYCLE
The adult worm inhabits the small intestines of the final host.
Gravid proglottids separate from the strobili, disintegrate and
release eggs in the feces.
The eggs are ingested by dif ferent species of adult and larval
insects like fleas, beetles, cockroaches, mealmoths and
earwigs.
In the hemocoele of these insects, the eggs develop into
cysticercoid larvae, which is the infective stage.
If these infected insects are ingested by the rat or
accidentally ingested by man, the larvae are released to
develop into adult worms in about three weeks.
 Hymenolepis diminuta

Intermediate hosts:
Ctenocephalides canis
Pulex irritans
Xenopsylla cheopis
Tenebrio spp.
Tribolium spp.

Pathology
Condition is usually asymptomatic
No auto infection
Mild diarrhea, abdominal pain and vague GI manifestations are
the noted symptoms

Diagnosis
Stool exam ova (fried egg appearance)
 H. nana H. diminuta
Common Dwarf tapeworm Rat tapeworm
name
Adult 2-4 cm 10-60 cm
Length
Adult - # of 96-840 800-1300
segments
Scolex Rhomboidal Club-shaped
shape
Scolex Present Present
Rostellum
Scolex 20-30 none
Spines
Mature Broad with 3 round testes Same as H. nana
segments and a bilobed ovary

Gravid Succular uterus filled with Same as H. nana

segments eggs
Eggs/Ova Spherical, oncosphere with
bipolar thickening from
which 4-8 polar filaments
arise with 3 pairs of lancet
shaped hooklets
Sub spherical oncosphere
without polar filaments with intra
laminar layer
with 6 lanceolate hooklets
arranged in fan-like
 Raillietina garrisoni

Raillietina garrisoni is a common tapeworm in the Philippines,

although there have been Raillietina sp. Described in East
Asia and South America.
Human infection is accidental.
 Raillietina garrisoni

MORPHOLOGY
Adult:
The scolex is subglobular and is provided with four cup -like
suckers and a retractile rostellum.
Comma-shaped spines are present in both the suckers and the
rostellum.
More prominent are the two rows of alternating hammer -
shaped hooklets around the rostellum.
The mature proglottid has a bilobed ovary
The hexacanth embryo is enclosed in two thin membranes.
 Raillietina garrisoni

LIFE CYCLE
The adult tapeworm inhabits the small intestines of rat or
man.
When the gravid proglottids are separated from the strobila,
they are passed out with the feces.
These gravid segments may be ingested by the insect
intermediate host the flour beetle ( Tribolium confusum),
where the eggs will hatch and develop into cysticercoid larvae
in the hosts hemocoele.
With the accidental ingestion of the infected insects, the
cysticercoid larva becomes attached to the intestinal villi
where it will eventually develop into the adult in about 8
weeks.
 Dipylidium caninum

This tapeworm is a common parasite of dogs and cats

worldwide but it can accidentally cause dipylidiasis in man.
It is also known as the dog tapeworm or the double -pored
tapeworm.
Common name: Double-pored tapeworm, Dog tapeworm
Disease: Dipylidiasis or Dog tapeworm infection
Only tapeworm with 2 genital pores because it has 2 sets of
reproductive organs
Common parasite of dogs, cats and foxes and causes zoonotic
infection in man
 Dipylidium caninum

MORPHOLOGY
Adult:
The scolex is small and globular with four deeply cupped suckers and
a protrusible rostellum which is armed with 1 to 7 circles of rose -
thorn-shaped hooklets.
The proglottids are narrow, provided with a double set of reproductive
organs and a genital pore on each lateral margin.
The gravid proglottids are pumpkin-seed-shaped and are filled with
capsules or packets of about 8 to 15 eggs each, enclosed in an
embryonic membrane.

Egg:
Spherical, thin-shelled, and has a transparent albuminous covering.
Each egg contains a hexacanth (six-hooked) embryo.
 Dipylidium caninum

LIFE CYCLE
The adult worm inhabits the small intestines of man, dog or cat.
The distal-most proglottids are separated from the strobili and
are evacuated in the stool.
Disintegration of the gravid segments usually takes place in the
environment. Upon disintegration, egg capsules are released.
The egg capsules which are deposited on the ground are ingested
by the larval stage of the dog flea ( Ctenophalides canis), the cat
flea (Ctenophalides felis) or the human flea (Pulex irritans). The
dog louse (Trichodectes canis) may also be involved.
The hexacanth embryo (also known as the oncosphere) escapes
from the egg after hatching in the intestine and develops into
the adult stage in 3 to 4 weeks.
 Dipylidium caninum

Natural Or Definitive Hosts:

Dogs
Cats
Other caniids
Accidental Host:
Man
Intermediate Hosts:
Dog fleas ( Ctenocephalides canis)
Cat fleas ( Ctenocephalides felis)
Human fleas ( Pulex irritans)
Dog louse ( Trichodectes canis)

Diagnosis
Based on the recover y of the characteristic eggs in capsule or the
proglottids passed out in feces
 Echinococcus granulosus

The adult stage of minute tapeworm E. granulosus inhabits

the intestines of dogs and other Canidae.
Man gets hydatid disease ( aslo known as unilocular
echinococcosis or echinococcus disease) through ingestion of
infective ova. In this case, man becomes an accidental
intermediate host.
The usual intermediate host is the sheep.
The smallest tapeworm parasitizing man.
Common name: Hydatid worm
Disease: Unilocular echinococcosis or Hydatid disease
 Echinococcus granulosus

MORPHOLOGY
Adult
Smallest, shortest but deadliest tapeworm
Scolex:
Pyriform with 4 suckers and a rostellum armed with 28 to 50 hooks
Neck:
Short and thick
Strobila:
Usually consists of 3 proglottids
The gravid segment is the longest and broadest, the mature segment
is the narrowest
In gravid segment, the uterus resembles a loosely twisted coil
 Echinococcus granulosus

Lar va
Hydatid cyst
Found in the various organs of man and other IH
It represents the scolex of the future adult worm and remains invaginated
within a vesicular body
In man, it is typically unilocular, subspherical and is filled with fluid
The wall of the cyst is composed of 2 layer s:
Outer laminated layer Ectocyst
Inner germinal layer Endocyst
These membranes produce structures called brood capsules and protoscolices.
Fluid accumulates as the cyst grows which is potentially toxic and if this
fluid splits into body cavities, anaphylactic shock and death may occur
Spillage and escape of protoscoli ces can lead to development of cysts in
other site because the protoscolices have the germinative potential to form
new cyst
Then, the brood capsules and daughter cysts disintegrate within mother
cyst liberating the accumulated protoscoli ces which are known as the
Hydatid S and
 Echinococcus granulosus

Hydatid Fluid
Clear, colorless
Provides nourishment to the growing brood capsule and
scolices
Slightly acidic (pH 6.7), rich in electrolytes and has a low
specific gravity (1 to 1 .010)
Antigenic and highly toxic

Ova/Eggs
Infective form
Sub-spherical with radially striated egg shell, brown in color
similar to Taenia eggs.
 Echinococcus granulosus

LIFE CYCLE
The definitive hosts are dogs and other canines.
The adult tapeworm inhabits the small intestines and is attached
to the villi.
The gravid proglottids rupture, discharging the few eggs which
are passed out in the feces of dogs.
The embryonated eggs are infective, when ingested by a suitable
intermediate host such as sheep, dog, ox or man, the eggs hatch
in the duodenum, and the oncosphere penetrates, the intestinal
wall, and is carried by the lymphatics and blood circulation to
various organs and tissues to become hydatid cyst.
Organs frequently infected are the liver and lungs.
The hydatid cyst is infective. When a definitive host consumes
the viscera of infected intermediate hosts, the scolices freed
from the hydatid cyst attach to the intestines and develop into
adult tapeworms.
 Echinococcus granulosus

Pathology
Since the cyst grows slowly, the symptoms usually appear 5
to 20 years after
2 types of cystic echinococcosis:
Primary cyctic echinococcosis occurs after per oral infection with
the ova which subsequently gives rise to hydatid cysts in diferrent
parts of the body
Secondary echinococcosis occurs by rupture of primary hydatid cyst
by trauma
 Echinococcus granulosus

Diagnosis
Aspiration of cyst contents may demonstrate protoscolices.
Radiologic exam:
X-ray
CT scan
MRI
Serological tests:
CFT, IHA, CIEP
Casoni Intradermal Test
Hydatid fluid microscopy direct mount examination of
centrifuged deposit of the fluid. In LPCB wet mount, scolices
and protoscolices appear deep blue. Acid fast staining can
also be used (pink or purple)
Histopathologic Diagnosis FNAB, PAS stain
 Echinococcus granulosus

Reservoir, source and transmission of infection

Strictly zoonosis
Transmission from man to man or transmission from one IH to
another does not occur
Main source of infection: vegetables and water contaminated
with dog feces containing hexacanth eggs of parasite
MOT:
Direct contact with infected dogs the dog carries eggs on its tongue
from its anal areas and spreads to different parts of its body during
licking of its body with tongue
Indirectly through food and water
Coprophagic flies which may serve as mechanical vector of eggs
 Echinococcus multilocularis

Fox tapeworm
Principally is a parasite of foxes, occasionally of cats and dogs.
The larval stage causes Alveolar or Multilocular hydatid cyst in
man.
The adult parasite is relatively small in comparison to that of E.
granulosus.
Liver is commonly affected in man

Definitive host: Foxes

IH: Rodents
Accidental host: Man
MOT: Ingestion of vegetables, fruits contaminated with feces of
foxes