PHYLUM PLATYHELMINTHES
nana has no obligatory IH
Ø Flatworms-Dorsoventrally Flattened
Ø 4 Classes
• Turbellaria (ex. Planaria)
• Trematoda (Parasitic
Flukes/Trematodes/Digenea)
• Monogenea (Parasitic monogenetic
flukes)
• Cestoda (Tapeworms/Cestodes)
GENERALITIES OF CESTODES
Ø Class Cercomeromorphoae
Ø Segmented
Ø Triploblastic body design
• Endoderm
• Mesoderm
• Ectoderm
Ø Acoelomate- without body cavity
Ø Tegument: body covering
• Has muscles
• Glycolyx: composed of CHO
o Covers the tegument for
protection
o To prevent enzyme digestion
since it harbors the
gastrointestinal tract of the
host
• Mircrothrices: microthrix
o Specialized microvilli
o For absorption of nutrients
o Resist peristaltic movement
of the small intestine
o For protection
Ø Dorsoventrally flattened and bilaterally
symmetrical
Ø Possess a bilaterally symmetrical
excretory system, collecting tubules,
and capillaries which terminate in
“Flame cells”
Ø All species: heteroxenous
• Requires at least one IH
• EXCEPT: Hymenolepis nana
-FH is also the IH
-Larval stage also develops in
FH
JFFM2019
-H.
and can complete its life cycle
in a single host
Ø Ribbon-like/tape-like, flattened and
elongated
Ø Size varies from few millimeters to
several meters
• D. latum: Largest/Longest
tapeworm
• H. nana: Smallest
Ø Habitat:
• larval stage is encysted on the
tissues of the Intermediate host
• Adult tapeworms inhabits intestinal
tract of the definitive host
o EXCEPT: Echinococcus
granulosus (Adult lives in
tissues)
Ø Absent digestive Tract
• They get nourishment via the
tegument or body covering
• No gastrointestinal tract
Ø Lack Circulatory, respiratory and
skeletal System
Ø Egg
• Non-operculated
• Embryonated
• EXCEPT: Diphyllobothrium latum
-operculated
-unembryonated
Ø Adult Tapeworm
-Hermaphroditic/monoecious (sexes
are combined in a single organism)
-Structure
Scolex or Head
Ø important taxonomic structure
Ø serves as attachment to the definitive
host
Ø Anterior attachment structure
a. Acetabulate
• Acetabulum
• Suckers found on scolex
• 4 cuplike suckers (muscular)
• some possess protruding structure:
Rostellum
• Not all have rostellum
 • More globular Ø Strobila: chain of proglottids
• Hooks: for attachment Ø Strobilation: process of elongation of
• Rostellum can be the proglottid; growth of strobili
o Armed: with hooks attached to Ø Apolysis- detachment of gravid
rostellum proglottid from strobila
o Unarmed: without hooks Ø Infective Stage
b. Bothriate • Taenia –Cysticercus
• Almond-shaped • Dipylidium/Railletina/
• spoon or spatulate in appearance Hymenolepis –Cystecercoid
• 2 slit-like grooves or depressions: • Echinococcus-Hydatid cyst
bothria • Diphyllobothroum-Plerocercoid
o usually 2 per scolex Ø Pseudophyllideans have both uterine
o rare: more than 2 per scolex and genital pore, unlike
• No suckers, rostellum, or hooks Cyclophyllideans with genital pore only
• Ex. D. latum
ORDER CYCLOPHYLLIDEA
Neck Dipylidium Dog Tapeworm
Ø undifferentiated region posterior to caninum Double-pored Tapeworm
scolex Cucumber Tapeworm
Ø body production Pumpkin Seed Tapeworm
Ø region of growth that produces Echinococcus Hydatid worm
different segments granulosus
Ø Once attached to small intestines, it Hymenolepis Rat Tapeworm
will elongate nana
Ø Strobilization- production of Railletina Madagascar worm
proglottids from neck region garrisoni
o Apolysis-detachment of gravid Taenia saginata Beef Tapeworm
proglottid from strobili Unarmed tapeworm
Taenia solium Pork Tapeworm
Strobila or Body (segments/proglottids) Armed tapeworm
Ø Immature (near the neck) ORDER PSEUDOPHYLLIDEA
• sexes are undifferentiated Diphyllobothrium Fish tapeworm
• found at the anterior part latum Broad tapeworm
Ø Mature (middle) Spirometra
• contains the male and female
reproductive organs Phylum Phylum
• sexes are well differentiated Nemahelminthes Platyhelminthes
• found in the middle Body Pseudocoelomate Aceolomate
Ø Gravid (farthest/distal from neck) Cylindrical Dorsoventrally
flattened
• filled with eggs inside uterus Tegument villi microvilli
• farthest or distal from neck Digestive Complete Incomplete or
• no longer see reproductive system Absent
structures (degenerated
reproductive structures)
• Uterus: the only reproductive
structure present

JFFM2019

 Ø Species which require vertebrate I.H.
• Taenia solium (pigs/swine)
• Taenia saginata (cattles/cows)
Ø Species which require invertebrate
I.H.
• Dipylidium caninum
• Hymenolepis diminuta
Ø Species which may or may not require
I.H.
• Hymenolepis nana
Ø Species which infect man in their
larval stages
• Echinococcus granulosus (thorugh
hydatid cyst)
• Echinococcus multilocularis
• Taenia solium (through cysticercus
cellulosae)
• Diphyllobothrium latum (through
plerocercoid larva)*Sparganosis-
ingestion of copepods

JFFM2019

 Order Cyclophyllidea Order Pseudophyllidea
TRUE TAPEWORM FALSE TAPEWORM
Intermediate Requires only one Intermediate host Requires two Intermediate host
host required (lower forms of animals or 1st IH: copepods, 2nd IH: Freshwater fish
arthropods) Has indirect life cycle: need IH
Recovered Eggs and segments/proglottids Eggs
from patient
Mode of Ingestion of intermediate host containing the infective larval stage
Transmission
Scolex • Quadrate/cuboidal • Spoon-shaped
• Globular • Almond-shaped/spatulate
• 4 muscular, cup-like • 2 slit-like grooves (bothria)
suckers(acetabula) • No rostellum and hooks
• may possess rostellum (central
domed area wich may be armed or
unarmed with hooklets)
Strobila Apolytic (shed segments) Anapolytic (don’t shed segments)
• Detachable after eggs are • Not detachable after eggs are produced
produced • Proglottids do not breakdown
• Manner of detachment: single
or in chains
• 1st to be detached: gravid
proglottid
Vitellaria • Compact and condensed • Diffused with many follicles/scattered
• Found below the ovary • Found at lateral portion
Gravid • Degenerate reproductive organs • ALL reproductive organs are present
Proglottid • Ovary is bilobed
Uterus • Uterus is still present (branching • Rosette uterus (non-branching/coiled)
with different shaped and
patterns)
Uterine Pore • ABSENT • PRESENT
• Midventrally located
• Connected to uterus
• Exit point of eggs
Genital Pore Lateral portion, seen in gravid Near uterine pore (centrally located)
proglottid
Ova or eggs Spherical, non-opercualted, striated Oval, operculated, unembyonated (immature),
embryonated, Passed out readily Require aquatic involvement of the embryo
containing the hexacanth embryo (coracidium)
Life cycle 1. Embryonated egg 1. Embryonated egg (underwent
2. Oncosphere: contains hexacanth embryonation)
embryo 2. The larval stage
3. The different larval stage • 1. Coracidium
• Cysticercus (Taenia spp.) -hatches from embryonated egg
-Bladder worm: presence of -ciliated, swim in water when free
small scolex -Infective stage to the 1st
-has bag or sac Intermediate host (copepods)
• Cysticercoid (Hymenolepis, • 2. Procercoid
Dipylidium, Railletina) -emerges from coracidium
-with cercomer and hooks -tail portion: cercomer
• Coenurus -Infective stage to the 2nd
-invagination Intermediate host (fishes)
• Hydatid cyst (Echinococcus) • 3. Plerocercoid
-with brood capsule containing -no cercomer
protoscolices -found in 2nd Intermediate host
4. The adult stage -Infective stage to the Final host
• Larva may develop into adult 3. The adult stage
and lay eggs • Larva may develop into adult and
lay eggs

JFFM2019

ORDER PSEUDOPHYLLIDEA
Diphyllobothrium latum
Common Fish taperworm or Broad
name tapeworm
Final Host Man
Intermediate 1st IH-Copepods/crustaceans
host (Cyclops and Diaptomus spp.)-
contains the procercoid
2nd IH-Freshwater fish-contains
the plerocercoid(may live in the
fishes but undergoes no further
development: Paratenic host)
Paratenic Freshwater fishes: Salmon, Pike,
Perch, Walleye & Trout
Host
Infective Plerocercoid
stage
Habitat Small intestines (ileum)
Diagnostic Unembryonated eggs in stool
Stage
Mode of Ingestion of fish infected with
Transmission plerocercoid
Diagnosis -Stool exam (Identification of
operculated eggs with
abopercular knob in feces)
> Direct Fecal Smear
> Kato-thick
> Kato-Katz
> FECT
-Gastric Juice exam:
differentitate tapeworm anemia
from pernicious anemia
-Diagnostic Problem: Eggs are
confused with eggs of
Paragonimus spp.
-Demonstration of Proglottids
-Travel history or diet
Treatment Praziquantel or surgery
OVA
Morphology • Yellowish brown
• Moderately thick shell
• Inconspicuous operculum
• Small knob-like thickening
• With small abopercular knob
• Unembryonated: eggs will
embryonate in water (8-12
days)
Mistaken as Paragonimus westermani egg
JFFM2019
ADULT WORM
Scolex
Shape Almond shaped, spoon shaped,
spatulate
Suckers 2 slit-like grooves (bothria)
Neck Unsegmented, longer than scolex
Proglottids
Shape Wider than they are long
Segments 3000-4000 segments
Length can grow as much as 3-10
meters in length (largest and
longest tapeworm)
Set of Rep. 1
Organs
Testes Dorsolateral part of proglottid
Uterine pore rosette-like,coiled uterus
and uterus ovary: bilobed
Genital pores Centrally located
Lay 5pprox.. 1,000,000/day
Ø 13 known species (but only 1 out of
13 can infect man-D. latum)
Ø Paratenic host: Tranport host (does
not support the growth of the larval
stage of the parasite)
Ø PATHOLOGY
Broad or Fish tapeworm infection
(Diphyllobothriasis)-Acute infection
• Asymptomatic: majority of patients
• Mechanical obstruction
o (Infections are usually limited to
1 worm although there have
been reports that it is due to
large numbers of worms)
• Nervous disturbances
• Digestive disorders, non-specific
abdominal symptoms
• Abdominal discomfort
• Weight loss & weakness
Bothriocephalus anemia- Chronic
infection
• (cause diarrhea, nausea, intestinal
cramps and abdominal pain)
• Absorb high levels of Vitamin B12-
result to Hyperchromic (high MCH),
Megaloblastic (high MCV) anemia
with thrombocytopenia and
leukopenia
• Megaloblastic: lead to
Pancytopenia (decrease of RBC,
platelets, and WBC)
 Neutrophils: hypersegmented in
• ORDER CYCLOPHYLLIDEA
Peripheral Blood Smear
• Bothriocephalus Anemia: Dipylidium caninum
Pernicious-like anemia or Common Dog tapeworm or
megaloblastic-like anemia name double-pored tapeworm
• Vitamin B12 Deficiency-worm has Cucumber tapeworm
ability to split vitamin B12 from Pumpkin seed tapeworm
intrinsic factor Flea tapeworm
o Due to parasite competing Habitat Small intestine
for nutrients especially in Final host Dogs, cats
jejunum where absorption of
Accidental Man
Vit. B12 happens
host
• Mistaken for Pernicious Anemia
Intermediate • Ctenocephalides canis (dog
o True pernicious anemia:
problem in parietal cells host-harbors flea)
Sparganosis (Tissue infection) cysticercoid • Ctenocephalides felis (cat
• Due to larval forms of D. latum and flea)
Spirometra • Pulex irritans (human flea)
• Human sparganosis • Trichodectes canis (dog
o Ingestion of infected Cyclops louse)
with procercoid larv Infective IS tp the FH: Cysticercoid larva
o Drinking if contaminated stage IS to the IH: Embryonated egg
water with infected copepods Mode of Ingestion of IH containing
o Ingestion of raw infected transmission cysticercoid larva
flesh of amphibians and Pathogenesis • Usually asymptomatic
reptiles • Slight intestinal discomfort
o Using amphibians for • Epigastric pain
medicinal use • Diarrhea
• Sparganum can be recovered in • Anal pruritis
different parts of the body
• Some allergic reaction
• May cause local inflammation and
• Dipylidiasis in human is
eosinophilia
accidental
• Diagnosis: Surgical removal of
Diagnosis Stool exam
worms
-(egg capsules-rarely recovered
Bothriocephalus Pernicious from stool)
anemia anemia -Recovery of the proglottids in
Intrinsic Present, but it Absence of stool or perianal area
factor competes with Intrinsic factor Treatment Praziquantel
B12 (due to OVA
-parietal cell
Morphology • 8-25 thin-shelled eggs in egg
destruction
-H. pylori infection packets
-total or partial • Released by contraction of
gastrectomy proglottid
-Autoimmune • Spherical
disease • Thin-shelled
-hereditatry
• With hexacanth embryo
intrinsic factor
deficiency ADULT WORM
Gastric Presence of free Achlorydia Scolex
Juice HCL in the gastric Shape Pale reddish color, Small and
Exam juice globular

JFFM2019

Size 15-18 cm Raillientina garrisoni
Rostellum Conical and retractile rostellum, Other name Raillentina madagascariensis
armed with 1-7 rows of rose- Common Madagascar worm
name
thorn shaped hooklets
Final Host Rats
Suckers with four deeply cupped suckers
Accidental Man
(acetabula) host
Proglottids Intermediate Tribolium confusum (Flour beetle)
Shape Pumpin seed/cucumber shaped, host
vase-shaped segments Infective IS to FH: Cysticercoid larva
Length Proglottids are narrow stage IS to IH: Embryonated egg
Habitat Small intestine
10-70cm in length, longer than
Disease -Usually asymptomatic
wide
Manifestation -Childrens are usually affected
Sets of rep. two sets of male and female (proglottids are usually passed
organs reproductive organs and out)
bilateral genital pores (that is Diagnosis Stool Exam (eggs or proglottids)
why they are called double-pored Treatment Praziquantel
tapeworm) ADULT WORM
Gravid Melon seed or pumpkin seed Scolex
Shape Subglobular
Proglottid shaped, filled with egg
Rostellum Present, Armed
capsules/egg packets
Hooklets 2 alternating circular rows of
Capsules or contains 8-15 eggs enclosed in 90-140 hammer-shaped hooks
Packets embryonic membrane Suckers 4 cup-like suckers
Proglottids
Ø Most common intestinal parasite of Size 60 cm
cats and dogs Gravid shape Rice grain appearance, with ovoid
Ø Dry-looks like rice grain testes and bilobed ovary, motile
Ø Wet/moist-looks like cucumber and white
Gravid 2mm in length containing 200-
Multiceps multiceps proglottid 400 egg capsules
Other name Taenia multiceps Genital Pore Single, opens on the side near
Common Gid worm, Dog sheep tapeworm the anterior lateral border of
name segment
Final Host Dogs and other canines OVA
Habitat Small intestine Characteristic Each egg capsule contains 1-4
Intermediate Herbivores (sheep), man spindle shaped eggs
host Oncosphere Enclosed in 2 thin membrane
Accidental IH Huamn -outer elongated membrane
Infective Coenurus -inner spherical membrane
Stage
MOT Ingestion of herbivores Ø Common tapeworm of rats in
Disease GID DISEASE, COENUROSIS Philippines
Manifestation -Organs affected: eyes, brain
-Neurologic defects or blindness
Treatment Surgery
ADULT WORM
Characteristic Pear-shaped scolex with 2 rows of
22-30 hooks
Proglottids
Characteristic 1 lateral genital pore
EGGS
Characteristic Similar to Taenia eggs

JFFM2019

 Taenia saginata Taenia solium Taenia asiatica
–causative for Taeniasis - causative for Taeniasis -Closely related to
saginta solium T. saginata
Common name Beef Tapeworm or Unarmed Pork Tapeworm or Armed Asian Tapeworm
tapeworm tapeworm
Definitive host Man (cannot be an IH) Man (be both IH and DH) Man
Intermediate Cattle Pig and humans Pigs, cattle, goats, wild
host boars, and monkey
Infective stage Cysticercus bovis Cysticercus cellulosae, egg Cysticercus
Diagnostic stage Embryonated Ova in stool
Cysticercosis Does not occur May occur Does not occur
Autoinfection NO YES NO
nd
Mode of Ingestion of raw/undercooked 2 Intermediate host containing the infective larval
Transmission stage in the infected meat
Habitat Upper jejunum Upper small intestine Small intestine
OVA
Morphology • 30-45 um
• Oncosphere with 6 hooklets
• Spherical or subspherical in shape
• Thick brown Striated embryophore
• Prismatic appearance
SCOLEX
# of suckers Cuboidal with 4 cup-like Globular with 4 cup-like Similar to T. solium
suckers (acetabula) suckers (acetabula)
Hooks and Absent Present, double crown Rostellum: Prominent
rostellum armed with 25-30 hooklets Hooklets: Absent
PROGLOTTIDS
Segments 1000-4000 8000-10000 300-1000 segments
Length 4-10 meters 2-4 meters
Accessory Absent Present
ovarian lobe
Vaginal Present Absent Present
Sphincter
# of follicular 100-200 300-400
testes
GRAVID PROGLOTTID (Taller than wide and very motile)
Lateral Branches 15 to 20 (Tree-like 7 to 13 (finger like or 11-32 Lateral branches
appearance or dichotomous) dendritic appearance)
# of Ova 97000-124000 30000-50000

JFFM2019

PATHOLOGY AND MANIFESTATION • By-products of worm: systemic
intoxication
TAENIA SOLIUM • Non specific symptoms
• Epigastric pain
Disease Manifestation • Vague discomfort
• Weakness
Ø Taeniasis solium
• Weight loss
• Usually asymptomatic • Hunger pangs
• May experience vague abdominal • Loss of appetite
discomfort, hunger pangs, chronic • Pruritus ani
indigestion • Vague abdominal pains
• Mild,non-specific abdominal Obstruction
•
complaints (Proglottids are not o Bile & pancreatic duct
active) obstruction (due to the
• MOT: ingestion of cysticercus
motile gravid proglottid)
cellulosae
o Intestinal obstruction (due to
Ø Cysticercosis entangled proglottids)
• Tissue infection • Usually asymptomatic
• MOT: accidental ingestion of Taenia • High eosinophil levels
solium eggs found in food or drink Ø NO CYSTICERCOSIS
• Autoinfection
o Proglottids ruptures DIAGNOSIS OF TAENIA SOLIUM AND
-> release of embryonated TAENIA SAGINATA
eggs Ø EGGS: Stool exam; cannot be used for
-> eggs hatch oncosphere spp. determination
-> oncosphere migrates to • DFS
organs (preferred are • KATO-KATZ
voluntary muscles) • FECT
• Deposition of oncosphere (larva) in Ø PROGLOTTIDS: Number of uterine
different parts of the body branches
commonly in subcutaneous tissues • Double Slide Compression
(brain, muscle, bone, eyes) Technique
• More serious than Taeniasis solium o Use of india ink or Carmine
• Lodging of the larva in vital organs to visualize
and striated muscles o Inject stain via genital pore
• NEUROCYSTICERCOSIS: most Ø SCOLEX: After treatment or recovery
common parasitic disease of CNS; • Presence or absence of rostellum
larva goes to brain with hooks
• Loss of vision if larva targets brain • Taenia solium: with hooks
controlling vision • Taenia saginata: without hooks
Ø Perianal Swab
TAENIA SAGINATA Ø Coproantigen Detection: ELISA
Ø Molecular methods
Disease Manifestation Ø CYSTICERCOSIS of Taenia solium
Ø Taeniasis saginata • Surgery
• Large size • Xray, CT scan, MRI
• Serology

JFFM2019

 • Basis of suspecting May or may
Neurocysticercosis (NCC) not require IH
o Neurologic disorders (no obligatory
o Neuroimaging host), may
complete its
o Travel History
life cycle in a
• GOLD STANDARD FOR
single host
DETECTION: IMMUNOBLOT using
Infective Direct: Cysticercoid
purified glycoproteins (Western stage Embryonated larva
Blot) Ova
o Ab against cysticercal Indirect:
antigens (IgM and IgG) Cysticercoid
o Antibody detection larva
o CDC Recommendation Diagnostic Embryonated eggs in stool
• ELISA stage
• Molecular methods Mode of Ingestion
transmission
Habitat Small intestine
TREATMENT
Autoinfection YES NO
Ø DOC: Praziquantel or Niclosamide
Laboratory Stool Examination (look for
Ø Surgery for cysticercosis diagnosis eggs), concentration techniques
• Praziquantel and Albendazole Treatment Praziquantel
Ø Criteria for cure: ADULT WORM
• Recovery of scolex Scolex
• Negative Stool exam 3 months Shape Subglobular/ Knob-like/ knob
after treatment rhomboidal in shaped scolex
Ø BEST prevention: Thorough cooking of shape
meat Neck Long and slender
• Store at 20oC for 10 days kills Suckers 4 cup-like suckers (acetabula)
cysticerci Rostellum Armed Unarmed
(Prominent (Rudimentary)
• Cook at 65oC
and retractile)
Hooklets single row of Fan-like
Hymenolepis Hymenolepis
20-30 arrangement of
nana diminuta
Y-shaped hooklets
Common Dwarf Rat Tapeworm
hooklets
name tapeworm
Proglottid
Final host Man (Both IH Rats and mice
Size of 0.15-0.3 x 0.75 x 3.5mm
and FH), *Man-Accidental
Proglottids 0.8-1.0 mm (Larger)
harbors both host
# of 175-220 800-1000
adult and
segments
larval stage
Testes 3 ovoidal testes
Intermediate Insects:
Ovary Single bilobed ovary in a straight
host -Xenopsylla cheopsis (rat fles)
pattern across the segment
-Ctenophalides canis (dog flea)
Genital pore Unilateral (at the same side)
-Pulex irritans (human flea)
Uterus Irregular/sac-like
-Tenebrio or Tobolium (rice
beetle/flour beetle) OVA
-Ahasverus advena (saw-toothed Size Smaller (30- 60-80 um
grain beetle) 47 um in dm)

JFFM2019

Color Colorless/ clay Bile-stained Echinococcus granulosus
colored (yellowish to Common name Hydatid worm
brown) Final Host Dogs and other members of the
canine family
Shape Spherical or Fried-egg/
Intermediate Goats, horses, sheep, swine,
subspherical sunny-side up
host cattles, camels
appearance, Accidental Host Human (adult stages are not
More circular recovered)
Bipolar Present Absent Infective stage Hydatid cyst
Filaments and the larval
Outer/Inner Thinner outer characterized by form
membrane membrane thick, Habitat Small intestine (adult), tissues
(larva)
with translucent
MOT Ingestion
conspicuous outer
ADULT WORM
bipolar membrane Scolex
thickenings, in surrounding the Shape Pyriform/tear-drop shaped
which 2-4 hexacanth, with Rostellum Present, Armed
polar polar thickening Hooklets With 2 rows of 30-36 hooklets
filaments may Suckers 4 suckers
arise Proglottids
Only has three segments (immature, mature,
Others: Non-operculated, emryonated
gravid)
Size 3-6 mm
Ø H. nana Uterus location Centrally located, in the mature
• smallest cestode parasitizing man proglottid
• The most common cestode Gravid Largest of the segments
infection in the world Proglottid
Ø H. diminuta OVA
• most common parasite of rodents Resemblance Taenia egg, BUT NEVER SEEN
to IN HUMAN FECES
Shape Spherical to subspherical, with:
DISEASE MANIFESTATION
Inner layer: Germinal layer
Ø H. nana Outer layer: Laminal layer
• Usually asymptomatic Embryophore Striated
• Headache, Dizziness, Anorexia, Oncosphere is present with
Pruritus of nose & anus, Diarrhea, hexacanth embryo with three
Vomiting, Abdominal pain, Pallor, pairs of hooklets
Weight loss
• Infected children may appear Ø Smallest tapeworm of dogs (3-6
restless, irritable, sleep mm)
disturbances Ø There are 6 known species, but only 4
• Mere infections, mere are medically important
manifestations
• Causative for alveolar and cystic
Ø H. diminuta
echinococcosis
• Minimal and non-specific
o E. granulosus
• Shorter life span of parasite in
o E. multilocularis
human
• Causative for polycystic
• When accidental human infections
echinococcosis
occur-Hymenolepiasis
o E. vogeli
o E. oligarthus

JFFM2019

 Ø Unilocular Hydatid cyst
• Outer to inner layers:
o Host collagen capsule
(adventitial layer)
o Laminated layer
o Germinal layer
o Vesicles
o Brood capsule
o Protoscolices
• Larval stages formed through
vesiculation
• Numerous protoscolices may be
found within the cyst
• Cyst has outer laminated layer and
inner nucleated germinal layer
• When protoscolices and broad
capsules lie free in the cyst, these
are referred to as “Hydatid sand”
• Hydatid sand: structures that form
after bursting of hydatid cysts
o Renal involvement
Ø Primary pathology of Cyst:
Impairment of organs from
mechanical pressure
OTHER ECHINOCOCCUS SPP.
Echinococcus multilocularis
Ø Final Host: Foxes
Ø Intermediate host: Rodents (voles,
lemmings, shrews, mice)
Ø Causes: ALVEOLAR ECHINOCOCCOSIS
(liver cancer-like)
Ø Multilocular hydatid cyst: jelly-like
consistency
Echinococcus vogeli
Ø Final host: Bush dogs and dogs
Ø Intermediate host: Rodents
Ø Hydatid cyst
o Unilocular
o Osseous: vertebrae or ribs
o Alveolar

DIAGNOSIS
Ø X-ray, Roentgenogram
Ø Ultrasound, CT-scan, MRI
Ø Surgery, biopsy
Ø Exploratory cyst puncture
Ø Serology
• BFT: Bentonite Flocculation test
• Casoni Intradermal test
o Skin test, injected with
hydatid fluid
o (+) exposed to the parasite,
wheal and flare
DISEASE MANIFESTATION • ELISA

Echinococcosis-very serious human disease TREATMENT

in may parts of the world, according to WHO Ø Surgical resection
Ø Albendazole
Cystic Echinococcosis Ø Praziquantel
Ø Hydatid cyst Ø PAIR:
Ø Cysticercosis of Visceral organs • Puncture
Ø Organs affected: Liver and Lungs • Aspirate
Ø S/S: • Inject
• Simple cysts usually do not cause • Reaspirate technique
symptoms Ø Scolicidal agent: 95% ethanol
• Ruptured cysts can lead to hypertonic solution
symptoms of:
o Intermittent Jaundice and
Eosinophilia
o Brain involvement

JFFM2019