There are 2 important human pathogens in the genus Taenia
Humans are the definitive hosts for taenias Ie adult form exists in humans The oncosphere invades cattle tissues forming cysticercus This is a complex cyst Structure contains the embryonic form of the worm For the Pig tape worm Cysticercus stage C! develop in H"#!S producing pathology #ost pple with $eef tape worms are S%#PT&#TIC Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Important properties Scolex Can be identified by its scolex This has * suc(ers and a circle of hoo(s Gravid proglottids lso can be identified by its gravid proglottids which have +,-. primary uterine branches This feature is important because cannot distinguish the spp by loo(ing at the eggs/ #"S T loo( at uterus Eggs 0ggs appear the same microscopically as those of T. saginata and Echinococcus spp Scolex Has a scolex with four suc(ers $"T !& H&&120TS Gravid proglottids -+,2+ prmary uterine branches in contrast to T/ solium proglottids which have +,-. HS #&30 2T032 $3!CH0S This feature is important because cannot distinguish the spp by loo(ing at the eggs/ #"S T loo( at uterus Eggs 0ggs are morphologically indistinguishable from T/solium Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm) 4isease The adult form of Taenia solium causes taeniasis The larval form of Taenia solium causes cysticercosis Cause taeniasis The larvae do !&T cause cysticercosis In taeniasis5 the adult tape worm is located in the human intestine In cysticercosis5 a more dangerous se6uence occurs P03S&! I!70STS 8&3# 077S in food or water that has been C&!T#I!T04 with H"#! F0C0S In taeniasis5 the adult tape worm is located in the human intestine 0pidemiology The epidemiology of taeniasis is related to ccess of pigs to human feces nd to the consumption of raw or undercoo(ed por( 4isease occurs worldwide but is endemic in some areas of sia5 South merica and 0astern 0urope 9 0pidemiology of cysticercosis is related to contamination of food or water with human feces In addition to the access of pigs to human feces and to the consumption of raw or undercoo(ed por( 0pidemiology is related to ccess of cattle to human feces nd consumption of raw or undercoo(ed beef 4isease occurs worldwide $"T is endemic in frica5 South merica and 0astern 0urope 3oute of infection In taeniasis5 the adult tape worm is located in the human intestine This occurs when humans are infected by eating raw or undercoo(ed por( containing the larvae or cysticerci cystircercus consists of a pea si:ed5 fluid filled bladder with an invaginated scloex From NOTES T/ solium also infect man as the larval stage Route of infection: $y ingesting eggs Contamination of food by fecal matter from someone with pig tape worm H0!C0 can get cysticercosis 0;0! if you 4&!<T eat por( &r possibly by =Internal autoinfection> This route is less clear/ Suspect that a segment of the worm gets bac( into the stomach from the intestines and dissolves/ 0ggs are released and this appears to mimic the swallowing of eggs/ P03S&! I!70STS 8&3# 077S in food or water that has been C&!T#I!T04 with H"#! F0C0S Note that in cysticercosis, humans are infected y eggs excreted in human feces, not y ingesting undercoo!ed por!" !ote also the PI7S 4& !&T H;0 TH0 4"2T worm in their intestines so they are !&T the source Humans are infected by eating raw or undercoo(ed $00F containing larvae Cysticerci of eggs that cause human cysticercosis Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm) 2ife cycle #out the hosts Humans are the definitive hosts Pigs are the intermediate hosts #out the life cycle In the small intestine5 the larvae attach to the gut wall and ta(e about ? months to grow into adult worms measuring up to +m The gravid terminal proglottids containing many eggs detach daily and are passed in feces and are accidentally eaten by pigs !ote that pigs are infected by the worm eggs TH030F&305 it is the larvae 'cysticerci) that are found in the pigs @ hoo(ed embryo 'oncosphere) emerges from each egg in the pig intestine The embryos burrow into the wall into a blood vessel and are carried to s(eletal muscle They develop into cysticerci in the muscle5 where they 30#I! till eventually eaten by a H"#! 9 Cant really complete the cycle5 unless someone happens to ingest the cysticerci in human fleshA #out the hosts Humans are the definitive hosts Cattle are intermediate hosts #out the life cycle In the small intestines5 the larvae attach to the gut wall and ta(e about ? months to grow to adult worms measuring about -.m The gravid proglottids detach and are passed in feces and eaten by cattle The embryos oncospheres emerge from the eggs in the C&8s intestines and burrow into a blood vessel where they are carried to s(eletal muscle In s(eletal muscle5 they develop into cysticerci The cycle is completed when cysticerci are I!70ST04 Pathogenesis dult tapeworm attached to the intestinal wall causes 2ITT20 damage The 077S hatch in the small intestine The oncospheres burrow through the wall into a blood vessel They can then disseminate to many organs 0SP0CI22% TH0 0%0S !4 TH0 $3I! where they encyst to form cysticerci Cysticerci can become very 2370 esp in the $3I! where they manifest as a space occupying lesion 2iving cysticerci do not cause inflammation5 $"T when they 4I05 they release substances that provo(e an inflammatory response 0ventually5 the cysticerci calcify 2ittle damage results from the presence of adult worm in the small intestine Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm) Clinical findings #ost pple with adult tape worms are asymptomatic These symptoms can occur norexia 4iarrhea Some may notice proglottids in the stools From NOTES Cysticerci '=bladder worms>) found in tissues including brainB may cause epilepsy5 encephalitis5 hydrocephalus 8&3ST infection is in the brain Cysticercosis in the brain causes Headache ;omiting Sei:ures Cysticercosis in the eyes ppears as uveitis or retinitis Subcutaneous nodules containing cysticerci commonly occur #ost pple with a adult tape worms are asymptomatic $"T malaise and mild cramps can occur Proglottids may appear in the stools #ay even protrude from the anus Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm) 4iagnosis From NOTES Proglottids may be noticed in faecesB Can differentiate T/ solium from T/ saginata SH&"24 2&&1 T& P3&72&TTI4S T& 4IFF03!TIT0 TH0 SPP 0ggs seen in faeces 'H&80;03 TH0S0 30 I40!TIC2) Identification of T. solium consists of finding gravid proglottids with +,-. primary uterine branches in the stools 0ggs are found in the stools 20SS often than the proglottids From NOTES Serology CT5 #3I scans Calcified lesions in muscles Can see calcified lines5 which represent the dead calcified cysticerci #3I is good at resolving detail/ #ay even see embryo in the cysts 4iagnosis of cysticercosis depends on demonstrating the presence of the cyst in tissue5 usually by surgical removal or CT scan Serologic tests that detect antibodies to T/ solium antigens are available5 $"T #% $0 !07TI;0 I! In contrast to T.solium5 T.saginata proglottids have -+,2. primary uterine branches 0ggs are found in the stools 20SS often than the proglottids !0"3&C%STIC03C&SIS Spp Taenia solium 'the por( tapeworm) Taenia saginata 'the beef tapeworm) Taeniasis 'caused by adult worm) Cysticercosis 'caused by larval form) Taeniasis 'caused by adult worm) Treatment From NOTES Intestinal Taenia tapewormB niclosamide T/ soliumB some physicians would give an antiemetic an hour before starting treatment This is to prevent irritation in the intestinal tract from treatment from producing reverse peristalsis which can lead to segments of the worm ending up in the stomach thus creating ris( of patient developing cysticercosis/ Pra:i6uantel also effective From $evinsons Intestinal worms tx of choice is pra:i6uantel F3&# !&T0S Cerebral 'neuro,) cysticercosisB 0CP03T &PI!I&! !00404 70!0322% use antihelminth drugs with anitinflammatory drugs Consider alenda%ole or pra%i&uantel5 under supervision !&T0 that !&T every patient re6uires antihelminth treatment/ !eed expert opinion/ Chec( with neurologist/ Steroids D treatment leads to inflammation around damaged cysts 'C!S symptoms may worsen due to inflammation produced after the cyst is (illed hence need to use anti,inflammatory drugs/) #nti'epilepsy medication as necessary 'eg if the patient presents with epilepsy) From $evinsons Tx for cysticercosis is also pra:i6uantel $"T surgical excision may also be necessary lbenda:ole is an alternative to pra:i6uantel Intestinal worms tx of choice is pra:i6uantel Prevention Prevention of taeniasis involves Coo(ing por( ade6uately 4isposing of waste properly so that pigs C!!&T ingest human feces Prevention of cysticercosis consists of Tx of patients to P30;0!T "T&I!F0CTI&! &bservation of proper hygiene including hand washing to prevent contamination of food with the eggs Prevention of taeniasis involves Coo(ing beef ade6uately 4isposing of waste properly so that cattle C!!&T ingest human feces