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General Characteristics

Flat, ribbon-
like
White or
yellowish
Dorsoventrally
flattened
Few mm to
several meters
Sexes are not
separate
General Characteristics
Adults are found in the intestinal tract of man
Body cavity and alimentary cavity are absent
Excretory and nervous systems are present
Complete reproductive system is present in every
proglottid
Regions in Adult Worm
Scolex
Head
Suckers
Hooks
Neck Strobila
Body trunk
Proglottids
Types of Proglottids
Immature
Male and female organs are not differentiated
Mature
Male and female organs have become
differentiated (male organs appear first)
Gravid or ripe
Uteri are filled with eggs (other organs have
atrophied or disappeared)
Differences
Points of
differences
Pseudophyllidean Cyclophyllidean
Scolex Spoon-shaped with
slit-like sucking
grooves called
bothria, no hooklets
Quadrate, with 4
cup-like suckers
with or without
rostellum
Strobila Anapolytic
Do not shed
segments
Apolytic
Shed segments
Differences
Points of
differences
Pseudophyllidean Cyclophyllidean
Gravid
proglottid
All reproductive
organs are present
Uteri coils in rosette
form
All reproductive
organs degenerate
except uteri
Pore Uterine pore
Median ventral
surface
Genital pore
Lateral margin of
proglottid
Differences
Points of
differences
Pseudophyllidean Cyclophyllidean
Ova Oval operculated
immature
Spherical non-
operculated
embryonated
Larval stages Coracidium
procercoid
plerocercoid or
sparganum
Cysticercoid
cysticercus
hydatid
Differences
Points of
differences
Pseudophyllidean Cyclophyllidean
Intermediate
host
2
Crustaceans
Fresh water fish
1
Lower forms of
mammal
Arthropod
Diphyllobothrium latum

http://www.revistaaquatic.com/aquatic/html/art1401/fig11.gif 3-01-08
Fish
Tapeworm
Broad
Tapeworm
Diphyllobothrium latum

http://www.revistaaquatic.com/aquatic/html/art1401/fig11.gif 3-01-08
Yellowish grey
Strobila - egg-filled
uterus
3 -10 m in length
5 -15 years
Diphyllobothrium latum

Scolex
Spatulate or spoon
Bothria
No rostellum and no hooklets
Diphyllobothrium latum

Proglottid
Mature
reproductive
organs
Terminal
shrink and
empty
Diphyllobothrium latum
http://pathmicro.med.sc.edu/parasitology/dip1.jpg 3-01-08
Rosette
form uterus
Diphyllobothrium latum
yOva
y Oval
y Unsegmented
y Inconspicuous
operculum at one end
and a small knob at
the other end
y A single egg gives rise
to a single larva
y Not infective to man

http://workforce.cup.edu/Buckelew/images/Diphyllobothrium%20latum%20egg.jpg 3-01-08
Diphyllobothrium latum
y Larva
y Passed first in water and then in the respective intermediate
hosts
y 3 stage
y First stage larva
y Coracidium
y Ciliated oncosphere that develops from egg in water
y Second stage larva
y Procercoid
y Spindle-like solid body with cephalic invagination
y Found inside the cyclops (the first intermediate host)
y Third stage larva
y Plerocercoid
y Head is invaginated in the neck
y Found in the fresh water fish, the second intermediate host

Diphyllobothrium latum
y Final Host
y Man, dog, cat
y Small intestine
y 1
st
I.H.
y Cyclops or Diaptomus
y 2
nd
I.H.
y Fresh water fish, pike, trout, salmon, perch
y Mode of Infection
y Ingestion of imperfectly cooked infected fish or roe containing
plerocercoid larvae
y Infection
y Diphyllobothriasis
y G.I. disturbances and anemia
y Diagnosis
y Microscopic examination of feces for the characteristic
operculated eggs
Taenia saginata
y Beef Tapeworm
y Unarmed Tapeworm of
Man
y Adult worms are white
and semi-transparent
y Measures about 5-10
meters or sometimes
up to 24 meters
y Live up to 10 years or
more

Taenia saginata
y 1,000 to 2,000 proglottids

y Common genital pore is
marginally situated

y Vagina is provided with a
sphincter muscle

y Gravid proglottid consists
of a uterus and a central
longitudinal stem with 15
30 branches on each side

Taenia saginata
Taenia saginata
y Ova
y Liberated by rupture of
ripe proglottids
y Spherical
y Thin, outer transparent
shell
y Inner embryophore is
brown, thick walled and
radially striated
y Has an oncosphere with 3
pairs of hooklets
y Eggs are resistant and
remain viable for 8 weeks
y Infective only to cattle

Taenia saginata
y Final Host: Man
y Intermediate Host: cattle, cow buffalo
y Mode of Infection; eating beef containing Cysticercus bovis
y Pathogenesis
y Taeniasis
y Passage of proglottids in stool
y Mild irritation at site of attachment
y Epigastric pain
y Hunger fangs
y Weakness
y Weight loss
y Loss of appetite
y Pruritis
y Obstruction in intestine but also in bile and pancreatic ducts and
appendix because proglottids are actively motile
Taenia saginata
y Diagnosis
y Identifying characteristic eggs, proglottids or scolex
y Usual specimen is gravid proglottids ( lateral branches 15-20)
y Concentration techniques for eggs (eggs rarely passed out in
stool)
y Perianal swabs
y Treatment
y Praziquantel
y 5-10mg/kg single dose
y Criteria for cure
y Recovery of the scolex
y Negative stool examination 3 months after treatment

Taenia solium
yPork Tape worm
yArmed Tapeworm of Man
yTaeniasis is common among those
eating raw or insufficiently cooked
measly poil
yUncommon among non-pork
eaters

Taenia solium
y Scolex is globular in
outline with 4 circular
suckers
y Scolex has a rostellum
armed with a double
row of alternating large
and small hooklets
y Rostellar hooklets are
shaped like daggers or
Arabian poniards


Taenia solium
Taenia solium
Taenia solium
y Adult worms measure
2-3 meters
y Adult worms live up to 25
years



Taenia solium
y 800-900 proglottids
y Common genital pore is
marginal and thick lipped
y Vaginal opening is not
guarded by a muscular
sphincter
y Gravid segments are
expelled passively in chains
of 5-6 at a time and not
singly.
y Gravid proglottids contains
approx. 30,000 to 50,000
eggs

Taenia solium
y Ova
y Same as those of Taenia
saginata
y Infective to man as well
as pigs
y Thick brown striated
embryophore
surrounding a
hexacanth embryo
Taenia solium
y Final Host: Man
y Intermediate Host: Pig
y Mode of infection; eating measly pork containing
Cysticercus cellulosae
y Diagnosis: stool examination for proglottids/eggs


Taenia solium
y Pathogenesis
y Mild, non-specific abdominal complaints
y Proglottids are not as motile as T. saginata so organ obstruction is
less likely.
y Cysticercosis
y Multiple
y Develop in any organ or tissue
y Neurocysticercosis (most serious zoonotic disease)
y Chorioretinitis
y vasculitis

Taenia solium
y Diagnosis
y Intestinal
y Identifying the characteristic proglottids, eggs or scolex
y Cysticercosis
y Computed Axial Tomography
y Magnetic Resonance Imaging

y Treatment
y Praziquantel: 5-10 mg/kg single dose for children and adults
y Niclosamide not available locally
y Criteria for cure:
y Recovery of scolex
y Negative stool exam 3 months after treatment
Comparison Between
T. saginata and T. solium
Taenia saginata Taenia solium
length 5-10 meters 2-5 meters
Head or scolex Large, quadrate, no
rostellum and hooks
Armed; with rostellum;
with hooklets
Number of proglottids 1,000 to 2,000 Below 1000
Expulsion Expelled singly and may
be forced through the
anal sphincter
Explelled passively in
chains of 5 or 6
uterus Highly branched with 15-
30 lateral branches on
each side; thin;
dichotomous
Lateral branches 5-10 on
each side, thin, dendritic
and vaginal sphincter is
absent
testes 300-400 follicles 150-200 follicles
Echinococcus granulosus
y Taenia echinococcus
y Dog Tapeworm
y Hydatid Worm
y Man harbors the larval form and not the adult worms
which however is found in the intestine of dogs and
canines
Echinococcus granulosus
y Adult worms are small
(3-6 mm in length)
y It is composed of a
y Scolex
y Neck
y Strobila
y 3 segments
(occassionally 4)
y Immature
y Mature
y Gravid

Echinococcus granulosus
y Scolex bears
4 suckers
and a
protrusible
rostellum
with 2
circular rows
of hooks.

Echinococcus granulosus
y Ova
y Ovoid in shape
y Resemble Taenia ova
y Hexacanth embryo with 3
pairs of hooks
y Infective to:
y Man
y Cattle
y Sheep and other
herbivorous animals
Echinococcus granulosus
y Larva
y Found within the hydatid cyst developing inside the
intermediate host
y Represents the structure of the scolex of the future adult
worm
y Young larva are transformed into a hollow bladder (hydatis ,
drop of water)
y Brood capsules develop within the cysts and may contain
thousands of scolices
y On entering the final host, the scolex armed with a rostellum
and 4 suckers become adult worms

Echinococcus granulosus
y Definitive Host
y Dog
y Wolf
y Fox
y Jackal
y Intermediate Host
y Sheep
y Pig
y Cattle
y Horse
y Goat


Echinococcus granulosus
y Pathogenesis
y Echinococcosis
y Pathology is caused by the developing larval cyst in the
intermediate host
y Most common site of involvement is the liver
y Echinococcus granulosus cyst: Unilocular hydatid cyst
y Echinococcus multilocularis: alveolar cyst
y Some may be asymptomatic for years
y Rupture of cyst in the lungs may present coughing
accompanied by allergic reactions

Echinococcus granulosus
y Diagnosis
y Radiographic findings
y Immunodiagnosis
y Antibody detection
y IHA
y IFA
y EIA
y Antigen detection
Echinococcus granulosus
y Treatment
y Surgical resection: not 100% effective
y Solicidal agent
y Hibitane
y 95% ethanol
y Hypertonic
y 30% Normal Saline Solution
y PAIR technique for inoperable cyst
y Puncture, Aspiration, Injection, Reaspiration Intervention
Albendazole

Dipylidium caninum
y Double Pored Dog Tapeworm

y Presence of bilateral genital pores in each segment (di:
2; pylis: gate): 2 entrances

y Common intestinal parasite of dogs

Dipylidium caninum
yAdult
y 10-70 cm in
length
y Pale reddish

Dipylidium caninum
yScolex
y Small and globular
y 4 deeply cupped
elliptical suckers
y Protrusible/retract
ile rostellum
y Rostellum has 1-7
rows of rose thorn
shaped hooklets

Dipylidium caninum
Dipylidium caninum
yStrobila
y 200
proglottids
y narrow

Dipylidium caninum
yMature
proglottids
y 2 sets of male
and female
reproductive
organs
y Bilateral genital
pores


Dipylidium caninum
yGravid proglottids
y Have size and
shape of pumpkin
seeds
y Filled with
capsules or packets
of 8-15 eggs
enclosed n an
embryonic
membrane

Dipylidium caninum
Dipylidium caninum
y Ova
y Passed out in the feces
along with the proglottids
y Released by contraction of
proglottids or
disintegration outside the
host
y Spherical
y Thin shelled
y With a hexacanth embryo
Dipylidium caninum
yIntermediate hosts

y Ctenocephalides canis : dog flea
y Ctenocephalides felis : cat flea
y Pulex irritans : human flea
y Trichoedectes canis : dog flea

Dipylidium caninum
y Pathogenesis
y Dipylidiasis
y Rarely multiple
y Symptoms are minimal
y Slight intestinal discomfort
y Epigastric pain
y Diarrhea
y Anal pruritus
y Allergic reactions

Dipylidium caninum
y Treatment
y Praziquantel
y 5-10 mg/kg body weight single dose
y Epidemiology
y USA
y Rhodesia
y Argentina
y China
y Philippines
Hymenolepis species
y Genus is derived from the membranous character of the
egg slell lymen
y 3 testes in each mature segment
y Uterus is sac-like and transverse
y Eggs possess iwo membianes ouiei membiane is ilin and
transparent
y larval stage is called cysticercoid
y Small bladder containing the invaginated head proximally
and a solid, elongted portion as a caudal appendage
y There are 2 species;
y Hymenolepis nana
y Hymenolepis diminuta

Hymenolepis nana
y Dwarf Tapeworm
y Smallest tapeworm infecting man
y Found worldwide
y Mainly among children
y Only human tapeworm that can complete its life
cycle in a single host
y Man can harbor both the adult and larval stages of
the parasite
y Exception to the general rule that
Helminils do noi muliiply inside ile body of
ile definiiive losi
Hymenolepis nana
y Adult
y Found in the ileum
y Delicate strobila
y 25 mm to 45 mm
y Worms may be present in
large numbers from 1,000
to 8,000
y Short life span, about 2
weeks
y Up to 200 proglottids
y Transverse uterus
y 3 testes

Hymenolepis nana
y Scolex
y Subglobular
y 4 suckers
y Provided with a
short retractile
rostellum armed
with a single row
of 20-30 hooklets
y Rostellar
hooklets are
shaped like
tuning forks

Hymenolepis nana
y Ova
y Spherical or oval
y 2 distinct membranes
y Outer membrane is
thin transparent and
colorless
y Inner embryophore
encloses an
oncosphere with 3
pairs of lancet shaped
hooklets
y Intermembranous
space is filled with
yolk granules and 4-8
polar filaments
emating from little
knobs at either end of
the embryophore


Hymenolepis nana
y Mode of transmission is thru
y Direct
y Host ingests eggs that hatches in the duodenum
y Indirect pathway
y Accidental ingestion of infected arthropod intermediate host
like rice and flour beetles in which cysticercoid larva are
released nd develop into adult worms in the small intestine of
the host
Hymenolepis nana
y Pathogenesis
y Sympioms aie pioduced due io paiienis immunological iesponse
to the parasite
y Asymptomatic for light worm burden
y Headache
y Dizziness
y Anorexia
y Pruritus of the nose and anus
y Abdominal pain
y Pallor
y Desquamation of intestinal epithelial cell or as serious as
necrosis may occur
y Regulatory immunity will eventually limit the
infection
Hymenolepis nana
y Diagnosis
y Demonstration of characteristic ova in the stool
y Proglottids are not recovered because they undergo
degeneration prior to passage
y Treatment
y Praziquantel
y 25mg/kg single dose
y Drug dosage is higher than that of taeniasis because of
resistant cysticercoids in intestinal tissue
Hymenolepis nana
y Epidemiology
y Countries with warm temperature
y Southern USA
y Latin America
y Mediterranean
y East Asia
y Philippines

Hymenolepis diminuta
y Rat tapeworm
y Common parasite of rats and mice
y Accidental human infections
y Differs from Hymenolepis nana in morphology and
life cycle because it requires an intermediate host
y 2 Hosts
y Larval stage: cysticercoid is passed in fleas
y Adult stage: in rats and mice and accidentally in humans
especially children who accidentally ingest infected fleas

Hymenolepis diminuta
y Adult
y Larger than Hymenolepis
nana

y Measures 60 cm in
length


Hymenolepis diminuta
y Scolex
y Unarmed
rostellum
y 4 suckers


Hymenolepis nana
Hymenolepis diminuta
yProglottid
y 8,00 1,000
y Mature proglottids of
Hymenolepis diminuta
from the laboratory rat.
y The three spherical bodies
are testes which surround
the ovaries, ootype and
vitelline glands. The
genital pores are on the
left margin


Hymenolepis diminuta
yOva
y Larger than H.
nana
y Outer shell is
yellowish in color
y Inner embryohore
has 2 knob-like
thickenings
y No polar filaments

Hymenolepis diminuta
y cysticercoid of Hymenolepis
diminuta.
y The suffix indicates it is like a
cysticercus but this larva has no
bladder but instead has a tail.
y The dark body within the
spherical portion is the scolex.
y The longer the tail, the more
mature the cysticercoid.
y This stage is found inside an
insect such as the mealworm,

Hymenolepis diminuta
y Pathogenesis
y Hymenolepiasis
y Worm burden in rodents is relatively low
y In man, highest worm burden is 19
y Clinical manifestations are minimal and
non-specific
Hymenolepis diminuta
y Treatment
y Praziquantel
y 25mg/kg body weight single dose
y Epidemiology
y World wide
y Common among children due to ingestion of
infected grain beetles, dried fruits, flour and
cereals
y Prevalence of H. diminuta in Philippine rats is
about 8%

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