Taenia solium infection (pork tapeworm infection)

Notes
  • Definitive host is human while intermediate hosts are pigs.
  • Proglottids are motile and they shed eggs during their movements.
  • Statistics: Size of an adult worm - 2 to 7 m; number of worm infections per person - 1 or 2; number of proglottids per worm – up to 1000; number of eggs per proglottids – 50,000.
  1. Transmission
  • Life cycle;

_Adult worms in small intestine of human host.

_In each mature proglottid (as a hermaphrodite) self-fertilizes occurs to produce zygotes that multiply and differentiate into embryonated eggs (oncospheres).

_Oncopheres and gravid proglottids are shed in stool.

_Oncopheres and gravid proglottids are ingested by pigs. (Sometimes human beings may also act as intermediate hosts for T. solium larvae in case they ingest T. solium eggs from human excreta).

_Hexacanths (six-hooked larvae) are hatched.

_ Hexacanths penetrate the intestinal wall into the blood stream and they settle in the skeletal muscles and to a small extent in lungs and liver (within 70 days)

_Hexacanths transform into a cyst known as cystcerci solium.

_Human host feed on beef contaminated with cystcerci solium.

_The enzymatically released scolex  from cystcerci solium attaches itself on the intestinal wall and mature (5-12 wks)

NB: Retro-infection can occur when gravid proglottids are passed retrograde from the intestine to the stomach. In the stomach oncospheres hatch and dissimanate  to subcutaneous tissue, muscle, viscera, and the CNS

Symptoms
  • Abdominal pain
  • Mainly asymptomatic
  • Seizures and other neurologic signs due to neurocysticercosis.
Diagnosis
  • Motile proglottids and eggs in the stool
  • Eggs in the anal swab
  • CT / MRI /immunoassays for patients with CNS symptoms
Management

Either,

_Tabs Praziquantel 25 mg/kg TID X 2/7

Or;

Over 2 years: (children and adults): _Tabs/susp Albendazole 400mg OD x 3/7

Or;

_Tabs Niclosamid: Over 12 years: 4 stat or 2 stat then 2 after one hour. 6-12 years: 1-2 initially followed by 1-2 after one hour. 2-6 years: 1 stat then 1 after one hour.

  • For symptomatic neurocysticercosis give corticosteroids, anticonvulsants, and sometimes surgery, in addition to the above dewormers.
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