CESTODES GENERAL CHARACTERISTICS Majority are long, segmented and tape-like are called tapeworms Dorso-ventrally flattened Size

varies from a few mm to several meters Adult worms are found in the intestinal canal of man and animals head or scolex is provided with suckers and sometimes with hooks that serve as organs of attachment There are 3 regions in an adult worm: Head: scolex Neck Strobila (body or trunk) Consist of a series of segment called proglottids Sexes are not separate Body cavity is absent Alimentary canal is entirely absent Excretory and nervous systems are present Reproductive system is present and complete in each segment According to maturity of reproductive organs, three types of segments of the strobila can be recognized from the fron backwards Immature: male and female organs are not differentiated Mature: male and female organs have become differentiated (male organs appear first) Gravid: uteri are filled with eggs (other organs are atrophied or have disappeared)

Classification of Cestodes Infecting Man

I. Pseudophyllidean cestodes Possess false or slit-like grooves called bothria Adult worms in Intestine Diphyllobothrium latum: Fish Tapeworm Larval stages: Plerocercoid in Man Sparganum mansoni Sparganum proliferum II. Cyclophyllidean cestodes Possess cup-like and round suckers called acetabula Adult Worms in the Intestine Taenia saginata Taenia solium Hymenolepis nana Hymenolepis diminuta Dipylidium caninum According to Habitat II. Cyclophyllidean cestodes Possess cup-like and round suckers called acetabula Larval Stages in Man Hydatid cyst of Echinococcus granulosus and Echinococcus multilocularis Cysticercus cellulosa of Taenia solium Coenurus cerebralis of Multiceps multiceps Coenurus glomeratus of Multiceps glomeratus

Order Pseudophyllidea Characteristics Large worms consisting of a long chain of segments

head has two slit-like sucking grooves called bothria instead of suckers Uterine glands are widely scattered in the parenchyma and is composed of many acini Genital pores are on the ventral surface of the segment and are not marginal Uterus opens to the exterior through which eggs come out Eggs are operculated and can develop only in water; immature when oviposited and oncosphere gives rise to ciliated embryo Larval development proceeds in two intermediate hosts: First larval stage is called procercoid Second larval stage is called plerocercoid Diphyllobothrium latum Common Name: Fish Tapeworm Broad Tapeworm Morphology Adult worm is yellowish grey in color Dark central markings in the strobila are due to the egg-filled uterus Scolex is spoon-shaped or spatulate Scolex bears 2 slit-like grooves called bothria (1 on the dorsal surface and 1 on the ventral surface) Scolex has no rostellum and no hooklets Neck is thin and unsegmented and is much longer than the head Ova Passed out in the host s feces in large numbers Oval Bile stained Contains abundant granules and unsegmented ovum Inconspicuous operculum at one end and a small knob at the other end Does not float in saturated solutions of common salt

A single egg gives rise to a single larva Not infective to man larva Passed first in water and then in the respective intermediate hosts 3 stage First stage larva Coracidium Ciliated oncosphere that develops from egg in water Second stage larva Procercoid Spindle-like solid body with cephalic invagination Found inside the cyclops (the first intermediate host) Third stage larva Plerocercoid Head is invaginated in the neck Found in the fresh water fish, the second intermediate host Final Host Man, dog, cat Small intestine 1 I.H. Cyclops or Diaptomus 2 I.H. Fresh water fish, pike, trout, salmon, perch Mode of Infection Ingestion of imperfectly cooked infected fish or roe containing plerocercoid larvae Infection Diphyllobothriasis
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G.I. disturbances and anemia Diagnosis Microscopic examination of feces for the characteristic operculated eggs Order Cyclophyllidea Characteristics Large or small worms consisting of chains of segments Scolex is quadrate with four cup-like round suckers An apical rostellum with hooklets may be present Vitelline glands concentrated in a single mass Common genital pore is marginal (on lateral side of segment) No uterine opening for the exit of eggs from the gravid uterus Eggs only escape from the rupture or disintegration of ripe segments Eggs are not operculated and can develop only in the intermediate host, fully embryonated Oncosphere is never a ciliated embryo Larval development proceeds in one intermediate host Taenia saginata Beef Tapeworm Unarmed Tapeworm of Man Adult worms are white and semi-transparent Ova Liberated by rupture of ripe proglottids No uterine opening Spherical Thin, outer transparent shell Inner embryophore is brown, thick walled and radially striated Has an oncosphere with 3 pairs of hooklets Does not float in saturated salt solutions

Eggs are resistant and remain viable for 8 weeks Infective only to cattle Final Host: Man Intermediate Host: cattle, cow buffalo Mode of Infection; eating beef containing Cysticercus bovis Pathogenesis Taeniasis Passage of proglottids in stool Mild irritation at site of attachment Epigastric pain Hunger fangs Weakness Weight loss Loss of appetite Pruritis Obstruction in intestine but also in bile and pancreatic ducts and appendix because proglottids are actively motile Diagnosis Identifying characteristic eggs, proglottids or scolex Usual specimen is gravid proglottids ( lateral branches 15-20) Concentration techniques for eggs (eggs rarely passed out in stool) Perianal swabs Treatment :Praziquantel Criteria for cure Recovery of the scolex Negative stool examination 3 months after treatment Taenia solium

Pork Tape worm Armed Tapeworm of Man Taeniasis is common among those eating raw or insufficiently cooked measly pork Uncommon among non-pork eaters Scolex is globular in outline with 4 circular suckers Scolex has a rostellum armed with a double row of alternating large and small hooklets Rostellar hooklets are shaped like daggers or Arabian poniards Ova Same as those of Taenia saginata Infective to man as well as pigs Thick brown striated embryophore surrounding a hexacanth embryo Final Host: Man Intermediate Host: Pig Mode of infection; eating measly pork containing Cysticercus cellulosae Diagnosis: stool examination for proglottids/eggs Pathogenesis Mild, non-specific abdominal complaints Proglottids are not as motile as T. saginata so organ obstruction is less likely. Cysticercosis Multiple Develop in any organ or tissue Neurocysticercosis (most serious zoonotic disease) Chorioretinitis Vasculitis Diagnosis Intestinal Identifying the characteristic proglottids, eggs or scolex

Cysticercosis Computed Axial Tomography Magnetic Resonance Imaging Treatment Praziquantel Niclosamide not available locally Criteria for cure: Recovery of scolex Negative stool exam 3 months after treatment Echinococcus granulosus Dipylidium caninum Double Pored Dog Tapeworm Presence of bilateral genital pores in each segment (di: 2; pylis: gate): 2 entrances Common intestinal parasite of dogs Pale reddish Scolex Small and globular 4 deeply cupped elliptical suckers Protrusible/retractile rostellum Rostellum has 1-7 rows of rose thorn shaped hooklets Strobila 200 proglottids narrow Mature proglottids 2 sets of male and female reproductive organs Bilatera genital pores

Gravid proglottids Have size and shape of pumpkin seeds Filled with capsules or packets of 8-15 eggs enclosed n an embryonic membrane Ova Passed out in the feces along with the proglottids Released by contraction of proglottids or disintegration outside the host Spherical Thin shelled With a hexacanth embryo Intermediate hosts Ctenocephalides canis : dog flea Ctenocephalides felis : cat flea Pulex irritans : human flea Trichoedectes canis : dog flea Pathogenesis Dipylidiasis Rarely multiple Symptoms are minimal Slight intestinal discomfort Epigastric pain Diarrhea Anal pruritus Allergic reactions Treatment : Praziquantel http://www.dpd.cdc.gov/dpdx/html/MorphologyTables.htm