Cestode (tapeworm, 绦

虫)
 GENERAL INTRODUCTIONS

      Taxonomic position

Phylum platyhelminthes
Class Cestoda
Order Cyclophyllidae
Order Pseudophyllidae
    
 MORPHOLOGICAL FEATURES

 Flat and Segmented

 Scolex-equipped with organs of attachment:
 suckers, hooks, grooves
 Neck - germinal portion
 Strobila:
Proglottids
Immature proglottid
Mature proglottid
gravid proglottid
 MORPHOLOGICAL FEATURES

 Body wall: Tegument and  
                subtegument (syncytial layer);
                no coelomic cavity
 Monoecious

 Digestive system: completely 

                                    degenerated
 PHYSIOLOGY AND PATHOGENESIS

 Surface absorption capabilities

 Highly developed reproductive
functions
 Anaerobic metabolism
 All species are parasitic
 Pathogenic stage may be adult or the
larva
 LIFE CYCLE PATTERNS

1. Pseudophyllidae type
 Scolex provided 2 grooves - bothrium
 Need two intermediate hosts
 aquatic crustaceans
 fish or other vertebrate animals
 Life stages copepod
eggcoracidium  procercoid plerocercoid(sparganum)
 adult worm
 Spirometra mansoni – cause sparganosis
 Diphilobothrium latum – accidental infection in
humans
LIFE CYCLE PATTERNS

2. Cyclophyllidae type
 Scolex provided 4 suckers sometimes supplemented with
circular of hooks
 Need one intermediate host only -- usually mammals
 Life stages
egg hexacanth metacestode stage  adult worm.

 Taenia solium
 Teania saginata
 Echinococcus granulosus
 E. multilocularis
 Hymenolepis spp
Metacestode stage
 Larval stage of a cestode that develop in
the intermediate host.
 Cysticercus - Taenia spp.
 Hydatid cyst - Echinococcus granulosus
 Alveolar hydatid cyst - E. multilocularis
 Cysticercoid - Hymenolepis spp.
Important species
Taenia solium
Teania saginata
Echinococcus granulosus
Spirometra mansoni
Hymenolepis nana
Hymenolepis diminuta
 Taenia solium  ( 猪带绦虫 )   
  
Taenia saginata  ( 牛带绦虫 )  
 Taenia solium

GENERAL INTRODUCTION

• Worldwide distribution
• Large tapeworm
• Larval infection of Taenia solium may cause
serious clinical disease ---CYSTICERCOSIS
 Morphology
 Can be up to 2 to 4 meters long
 It has a globular scolex with four suckers and 2
circular rows of hooks (rostellum)
 The gravid proglottids are 5×10 mm with a 7-13
branched uterus
 The eggs of T. solium and T. saginata are
indistinguishable
scolex of T. solium.
 Gravid  proglottids  of  Taenia 
solium . Injection of India ink in the 
uterus  allows  visualization  of  the 
primary  lateral  branches.    T. 
solium   has  7  -  13  branches  on 
each  side.  Note  the  genital  pores 
in mid-lateral position. 

Taenia solium
 eggs of Taenia solium and T. saginata
The  eggs  are  rounded  or  subspherical,  diameter  31  -  43  µm,  with  a  thick 
brown embryophore. Inside each egg is an embryonated oncosphere with 6 
hooks.  A  complete  egg  always  has  the  primary  membrane  (shell)  that 
surrounds eggs. 
Cysticercus
Life cycle of  T.solium
 Main points of the life cycle
 Man is the only definitive host, but he can also
be the intermediate host for T.solium

 Pig is the important intermediate host for

T.solium

 Adult worm reside in the lumen of the upper part

of small intestine

 The infective stage to man are both egg/gravid

proglottid and cysticercus for T.solium
 A tapeworm larval cyst (cysticercus) is ingested
with poorly cooked rice-like meat

 The larva escapes the cyst and passes to the

small intestine where it attaches to the mucosa by
the scolex suckers

 The proglottids develop as the worm matures in 3

to 4 months
 Main points of the life cycle
 The adult may live in the small intestine as long
as 25 years and pass gravid proglottids with the
feces
 When eggs consumed by pigs in which they
hatch and form cysticerci
 T.solium eggs can also infect humans and cause
cysticercosis (larval cysts in lung, liver, eye,
maxillofacial region and brain)
 Eggs from ----auto-infection, external
 Eggs from ----auto-infection, internal
 Eggs from ----external
auto-infection
internal

man Egg man

external

Egg

auto-infection
external
Pathogenesis and clinical features
 Adult worm —Teaniasis
Light infections remain asymptomatic
Heavier infections may produce
abdominal discomfort, epigastric pain,
vomiting and diarrhea
 Metacestode stage –Cysticercosis
 The cysticercus stage of T. solium can be found
anywhere in the body -- subcutaneous, muscles, eye,
brain
 Regardless of the tissue affected, pathological
consequences are those of a space-occupying lesion
 Cysticerci in brain tend to grow a larger size than those
in other tissues
 The process of calcification may be accompanied by the
release of antigens -- inflammatory reaction
 Cysticercosis
 The incidence of cerebral cysticercosis can be as high 1 per
1000 population and may account for up to 20% of
neurological case in some countries (e.g., Mexico);
cysticercosis ocular involvement occurs in about 2.5% of
patients and muscular involvement is as high as 10%
(India).
 Cysticercus on the
eyeground

subcutaneous
nodules
pseudohypertrophy of muscle
Cysticerci in brain
Cysticerci in heart
Cysticerci in tongue
 DIAGNOSIS
 For adult worm infection (Teaniasis)
＊ History of eating raw pork
＊ Find gravid proglottids in feces
＊ Perianal swab to find eggs
 For cysticercosis
＊ Specific diagnosis is difficult to establish, the
history and adult worm infection attribute to
strong suspicion
＊ Biopsy to subcutaneous lesions
＊ Computerized axial tomography or magnetic
resonance imaging
＊ Serological examination for specific antibody
 Epidemiological distribution
World-wide distribution.
Epidemic in central and south America (Mexico), Africa,
South-east Asia, eastern Europe, Micronesia .

High prevenlence 
Medium prevelence
Low or no prevelence
Epidemic limited area
Data unavialable
 PRINCIPLES OF CONTROL
 Treat all patients to eradicate the source of larvae
parasitism
Pumpkin seed and areca nut ;
Praziquantel
 Avoid the fecal contamination of pig feed
 Modernization of raising pigs
 Pay attention to personal and food hygiene
 Intensive examination of the pork
 Adequate cooking or freezing of meat are effective
precautions
 cysticerci do not survive at temperatures below -10℃ and above
50 ℃.
Customs of pig husbandry
 Teania saginata
 Can be up to 4 to 8 meters long
 The scolex with four suckers
 The gravid proglottids with a 15-30 branched uterus
 The eggs of T. solium and T. saginata are
indistinguishable
gravid proglottid of T. solium gravid proglottid of T. saginata
LIFE CYCLE
 LIFE CYCLE
 Human is the only definitive host, cattle is
the intermediate host
 Adult worm reside in the lumen of the upper
part small intestine
 The infective stage to man is larva

 No cysticercus in human
 PATHOGENESIS

 The adult parasite induces some host reaction

 The process of calcification may be accompanied
by the release of antigens -- inflammatory
reaction
 DIAGNOSIS
 For adult worm infection
Find gravid proglottids in feces or
experimental inducing worm
 DISTRIBUTION
 T.saginata is prevalent in regions where
cattle are raised: Africa, Middle-East,
Central and South America, Europe and
Asia.
 PRINCIPLES OF CONTROL

 Treat the patients --Pumpkin seed and

areca nut; Praziquantel
 Modernization of raising cattle

 Intensive examination of the beef

COMPARISON OF THE TWO TAPEWORMS

T. solium T. saginata
Size 2-4m 4-8m

Scolex Rostellum & hooks No

Mature Proglottid 3 lobes of ovary 2 lobes of ovary

Gravid proglottid Uterine Branches<13 >15

Intermediate Host Swine & Human Cattle

Disease caused Taeniasis & cysticercosis Taeniasis only

Infective stage Egg & Cysticercus Cysticercus Only

Mode of infection Cross or autoinfection Cross only

Diagnosis Egg may be found in stool Perianal egg exam

Clinical significance Much more important Less than T. solium

Chemotherapy Should be instant Not so urgent