Compiled By: BSMLS 2-F: Segmented Adult Worms "Ribbon-Like" Appearance

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CESTODES Bothria – elongated mid-ventral and mid-dorsal grooves found in the spindle shaped scolices

(Compiled by: BSMLS 2-F) of Pseudophyllidean worms; true suckers; suckers of Pseudophyllidean
Terminology Bothridia – muscular projections form the scolex and may have leaf-like margins; fake suckers
Acetabulum – cup-shaped sucking disk with muscular wall
Cestodes – otherwise known as tapeworms; constitutes a class of Plathyhelminths; Definitive host – harbors sexual stage of parasite where parasites complete their
Segmented adult worms; “ribbon-like” appearance; sub-classified based development
on their eggs; inhabit the Small Intestine; D.H: man; some of the cestodes Intermediate host – harbors sexual or larval stage
are “armed” (when we say armed some of the tapeworms has “hooklets”
but some has no hooklets) Side Notes:
3 morphological classification of worm: Adult worm – Egg stage– Larva
2 Major Classification: Pseudophyllidean – only one known genus and
species of medical
importance belongs here.
Cyclophyllidean – most of the species of Cestode
belongs here; has 4 suckers
3 basic parts of Adult worm: Acetabulum/
 Head/Scolex – where the suckers (Acetabulum) found (cup-like
shape)
 Neck – band, mature, and form segment
REMEMBER: as long as the head/scolex and neck are remain
attached to the intestine, the infection will still persist.
 Strobila–body of parasite; subdivided into
segments/proglottids:
 Immature segment – reproductive organ of male and
female are inconspicuous
 Mature segment – both male and female are already
visible (usually the male reproductive organ will
developed first)
Bothria - Sucturial
 Gravid segment – fertilized eggs groove slit (spatula
Head/Scolex – an anterior organ of attachment shape)
Strobila – body composed of segments also known as proglottids
Rostellum – elongated and protrusible structure situated in the center of the scolex;
either have hooklets; some of its suckers are found in Cyclophyllidean species
Neck – the organ of growth; body region
Properties Cestodes Trematodes Nematodes Muscle cells of Cestodes
Shape Tape-like Leaf-like and Elongated,  Are characteristically slow contracting
segmented unsegmented cylindrical and  Non-striated muscles and lacks T-tubule
unsegmented  Contains myocytons
Head end Suckers present, Suckers present No sucker, no
some have No hooklets hooklets, some
Calcerous corpuscles
attached hooklets have well
Secretions found in the parenchyma of cestodes
developed buccal
Measures 12-32 m in diameter
capsule
Alimentary canal Absent Present but Complete from Contains inorganic components:
incomplete mouth to anus  Calcium
Body cavity Absent Absent Present  Magnesium carbohydrate
Sexes Monoecious Monoecious Diecious  Calcium phosphate
(except
Schistosoma) Side Notes:
Life cycle Requires two Requires three Requires one host Parenchyma – tissues that fill in the body of cestodes; has nutrients
hosts (except hosts (except (except filarial Corpuscles – cells that are not suspended; free-floating usually in blood vessels
Hymenolepis and Schistosoma) worms and
Diphyllobothrium) Dracunculus) Function of Calcerous corpuscles
Larva forms Cysticercus, Cercaria, Rhabditiform  have been hypothesized as being buffer against organic acids produced during
hydatid cyst metacercaria, larva, filariform
metabolism
coenurus, redia, miracidium larva and
 as depots for CO2 and ion or they may be even excretory products
cysticercoid, and sporocyst microfilaria
coracidium,
plerocercoid and Adult tapeworms maybe differentiated the following features:
procercoid  Taxonomic features:
o Scolex
Teguments and Parenchyma of Cestodes o Hooks
Teguments – a living tissue (syncytial membrane) which serves as a protective and o Rostellum
digestive organ; (How will the Strobila absorb nutrients? – by teguments) o Internal morphology for proglottids
Microtriches – a minute microvilli which covers the tegument of cestodes contains
glycocalyx; supports the absorption and secretion of nutrients; protects the organism Side notes:
from enzyme from the host Smallest tapeworm in medical importance – Echinococcus granulosus
 A layer of carbohydrates containing macromolecules Smallest tapeworm infecting man – Hymenolepis nana (direct; no I.H)
 Inhibits host chymotrypsin, pancreatic lipase, trypsin and absorb bile salts Larva encysted form – reside in tissue/muscles
Adult worm – reside in the Small intestine
Classification Based on the Habitat of the Cestodes  adult tapeworms are found in the small intestine of definitive host and larval
Intestinal Cestodes (Adult worm residing in human intestine) stage the encysted from.
 Diphyllobothrium species
 Taenia solium and Taenia saginata causing intestinal taeniasis Pseudophyllidean Cyclophyllidean cestodes
 Hymenolepis species cestodes
 Dipylidium species Scolex Bears two grooves Bears four suckers (some
(bothria) species bear rostellum
with hooklets)
Somatic/Tissue Cestodes (larvae in human muscles/organs)
Uterus Convoluted (rosette Branched and closed as a
 Taenia solium causing cysticercosis
shaped), un-branched, blind sac, no uterine pole
 Taenia multiceps opens at the uterine pole
 Echinococcus species Genital pore Situated ventrally in the Situated laterally
 Spirometra species midline
Vitelline gland Scattered throughout the Single mass behind ovary
Side Notes: segment
Diphyllobothrium latum (Pseudophyllidean) - 2 intermediate host and 1 definitive Eggs Covered one layer – egg Covered by two layer-egg
host shell shell and embryophore
Hymenolepis nana - 1 intermediate host and 1 definitive host Freshly passed eggs in Embryonated from the
feces are unembryonated beginning
Sub-class Cestode Eggs are operculated and Eggs are not operculated
the embryo is ciliated and the embryo is not
Order: Pseudophyllidean
cliated
Scolex: with bothria, with or without hooks
Larval form Solid Contains bladder like sac
Neck: Present or absent
Strobila: Variable
Side Notes:
Proglottids: anapolytic
Hexacanth embryo – Cyclophyllidean ; 3 pairs (hooklet)
Genital pore: lateral or dorsal
Testes: numerous
Ovary: posterior, vitellaria follicular, lateral or cortical and encircling other organ
Uterine pore: present

Order: Cyclophyllidean
Scolex:
General Characteristics
 does not have digestive tract
LIFE CYCLE
(Based on clinical manifestation) Cattle’s Life Cycle (I.H: Asexual reproduction)

MOT: ingestion of embryonated egg Lose egg shell


T. saginata – beef tapeworm; no hooklets; has 2 main host Duodenum
(Infective Stage of I.H) &
T. solium – pork tapeworm; armed tapeworm
embryophore
Both T. saginata and T. solium can cause intestinal taeniasis

Released
T. saginata (can cause intestinal taeniasis)  beef tapeworm (D.H: man; I.H:
Oncosphere
cattle/cows)
Man’s Life Cycle (D.H: sexual reproduction)

MOT: ingestion of raw/undercooked Suckers:


Hatch & Releasing encysted
beef contaminated w/encysted Small attach to the
suckers form of larvae
larvae/metacestode/CYSTICERCUS intestine S.I of the
exvaginate (remains in the
BOVIS (I.S of D.H) cattle
skeletal muscles of
beef meat)
Attach/ Portal
penetrate: Mature: larvae Skeletal circulation/m
Encystation (Hexacanth
Intestinal muscle esenteric
Cyclophyllidean – will lay automatically
mucosa embryo) lymphatics
embryonated egg

Pseudophyllidean – will lay unembryonated mature


egg

Male &
female adult
worms

Embryonted egg
(Passed to feces) Cross-fertilization/ self-
Initiates cattle’s life fertilization
cycle
T. solium – has hooklets; can cause Cysticersosis and I.T; autoinfection is common T. solium  Cysticercosis (DH & IH: Man)
Man’s Life Cycle/Cysticercosis
Man’s (DH) Life Cycle/Intestinal taeiniasis
MOT: ingestion of Small Released Attach and
MOT: ingestion of raw/undercooked Attachment/ embryonted egg intestine Oncosphere penetrate:
pork contaminated w/encysted Small
penetration intestinal
larvae/metacestode/CYSTICERCUS intestine
mucosa
CELLULOSAE
Mature (S.I)
External autoinfection
Blood
(fecal oral route;
(mesentery/ly
unhygienic) Adult male &
mphatics)
female worm
Embryonated egg Cross-fertilization/ self-
(Initiates I.H life cycle/ Pig’s fertilization Encysted larvae Subcutaneous
life cycle)
(not calcify) tissue/skeletal
Internal autoinfection (when muscles
peristalsis fails; causes Cysticercosis)
brain
eyes
I.H’s Life Cycle/ Pig’s Life Cycle pericardium

MOT: ingestion of Lose 2


coverings Attachment (S.I) T. solium
embryonated egg
and release Intestinal taeniasis Cysticercosis
Oncosphere D.H – Man D.H & I.H – Man
Penetrate to I.H – Pig (both sexual and asexual reproduction)
lymphatics
Parasite Biology (T. solium)
Egg: Hexacanth, cannot distinguish adult species; measures: 30-45 mm and have a
Inhabits pig’s thick brown striated embryophore
Encysted skeletal muscles Adult: inhabits the small intestine; shorter than T. saginata; measures:
larvae Proglottids: contains 800-1,000
(Cysticercus Scolex: contains 4 acetabulum
Encystation Larvae
cellulosae) has rostellum w/double crown of 25-30 large and small hooks
presence of accessory ovarian lobe smaller number of follicular testes
Gravid proglottid: contains 7-15 lateral branches  Cysticercosis suspected in the patient with epileptic seizures without
Contains approximately 30, 000 – 50,000 ova associated systemic symptoms
Infected meat is often called “measly pork”  CAT Scan (completed/computerized Axial Tomography)
Larval maturity is attached in approximately 12 weeks  MRI
 ELISA (highly sensitive but not specific)
Pathogenesis and Clinical Manifestation  Western blot for IgG and IgM (highly specific and sensitive)
 Infection results in mild non-specific abdominal complaint
Cysticercosis Delbrutto’s Diagnostic Criteria for Human Cysticercosis (found in the reference)
 Cysticerci develops in any organs A. Absolute Criteria (Gold Standard)
 Commonly located at striated muscle and brain  Histology of tissue biopsy to detect cysticerci
 Cyst may survive up to 5 years  Visualization of the parasite in the eye by fundoscopy
 Upon death, cystic fluid increases and there is a pronounced tissue response  a/MRI if brain-detect lesion confirmatory of neurocysticercosis (cyst
to the parasite w/characteristics scolex)
 Cerebral cysticercosis is the most serious manifestation of the infection; B. Major Criteria
parasite invades meninges  CT/MRI of brain-detect lesion of neurocysticercosis
 common manifestation of Cerebral cysticescosis  Serum/CSF antibody detection by western blot
o convulsions C. Minor Criteria
o along with usual and motor deficits; headache and vomiting D.
E. Epidemiologic Criteria
Cysticerci may be found in the following cerebral cortex, meninges, ventricles,  Residing in the endemic area
cerebral substances.  Frequent travel to endemic area
CSF shows:  History of contact w/another patient w/neurocysticercosis
 Increase pressure
 Elevated protein NOTE: confirmed diagnosis is one absolute criterion: two major criteria + one minor
 Decrease glucose criterion + one epidemiologic criterion
 Increase mononuclear cells
 CSF eosinophilic without peripheral blood eosinophilia Side Notes:
 Cysticercosis in the eye usually solitary subretinal or in the vitreous humor Prognosis for confirmed diagnosis
 2 major criterion + 1 minor criterion
Laboratory Diagnosis  1 major criterion + 1 minor + 1 epidemiologic
I.S – Cysticercosis cellulosae
D.S – eggs, scolex, proglottids Treatment
For T. solium
Praziquantel
 Adult: 5-10 mg/kg single dose  Measures: 30-45 mm in diameter
Niclosamide  Brownish in color thick embryophore
 Adult and children over 6 years old: 2 single dose after light meal followed by  Inside the egg shell is the oncosphere or embryo provided w/ 3 pairs of
laxative after 2 hrs hooklets
 Children 4-6 years old (larva) Cysticercosis: ovoidal, milky white 10m in diameter and has a single scolex
 Children 2 years old: 500 mg invaginated into fluid filled bladder
Albendazole in combination with praziquantel in cases of neurocysticercosis alone
with corticosteroids and anti-epilyptic drug Pathogenesis and Clinical Manifestation
T. saginata infection causes mild irritation at the site of attachment
Prevention and Control Symptoms:
 Exercising proper sanitation practices  Epigastric pain, vague discomfort
 Hunger pangs, weakness, weight loss, loss of appetite
Taenia saginata  Pruritus ani
 Known as beef tapeworm  Intestinal obstruction
 Human serves as a D.H  Obstruction of bile, pancreatic ducts, and appendix
 Anxiety and distress
Parasite Biology
Adult worm: inhabits the upper jejunum Laboratory Diagnosis
*Adult may live for 25 years Infective Stage: Cysticercus bovis
Measure: 4-10 m in length by 25 m Diagnostic Stage: Eggs (ACID FAST, scolex or proglottids)
Proglottids: 1,000-11,000
Scolex: Treatment
Mature Proglottids: square contains mature  Praziquantel
Male and female reproductive organs  Niclosamide
Two large lobes of ovaries and club-shaped uterus Criteria for cure: Recovery of scolex
Follicular testes: 300-400 scattered throughout the proglottids; the region has A negative stool examination 3 months after treatment (specifically
sphincter 3 consecutive 3 months)
Gravid proglottids: measures: 16x20 mm wide by 5-7 mm
97,000-124,000 ova; undergo apolysis Prevention and Control
*has 15-30 lateral branches per side  Exercising proper sanitation practices
Uterus: distended oval and has 15-20 lateral branches
Ova
 Spherical or subspherical
TAENIA SAGINATA TAENIA SOLIUM TAENIA SAGINATA TAENIA SOLIUM
ADULT WORM LIFE CYCLE
Length 4-6 meters or more 2-4 meters Disease Causes intestinal taeniasis Causes intestinal taeniasis
Head  Larger and  Small and globular and cysticercosis
quadrangular  Four suckers Host Definitive Host: Man For intestinal taeniasis:
 Four suckers present – not Intermediate Host: Cattle Definitive Host: Man
present which may pigmented Intermediate Host: Pig
be pigmented  Bears rostellum
 No rostellum, No with two rows of For cysticercosis:
Hooklets hooklets Both definitive and
 Hence called as intermediate Host: Man
armed tapeworm
Neck Longer Shorter Infective form Larva (cysticercus bovis) For intestinal taeniasis:
Larva (cysticercus
PROGLOTTIDS cellulosae)
No. of proglottids 1,000 – 2,000 800 – 1,000
Uterus Bears in 15 – 20 lateral Bears in 7 – 13 lateral For cysticercosis: Egg
branches branches
Lobes of ovary Two, No accessory lobes Three-two lobes with an Diagnostic form Egg For intestinal taeniasis: Egg
accessory lobe
Testes 300 – 400 follicles 150 – 200 follicles For cysticercosis: Larva
Vaginal sphincter Present Absent (cysticercus cellulosae
Measurements Gravid segment – 20mm x 5 Gravid segment – 12mm x deposited in tissue)
mm 6mm
Expulsion of segments Expelled singly in the feces Expelled in chain of 5-6 Mode of transmission Ingestion of contaminated For intestinal taeniasis:
segments beef ingestion of contaminated
pork
Eggs per segment 80,000 eggs per gravid 40,000 eggs per gravid
segment segment
For cysticercosis:
- Contaminated food
LARVAE
and water
Cysticercus bovis present in Cysticercus cellulosae
- Autoinfection
cattle’s muscle but NOT in present in pig’s muscle and
man also in man (muscle, eye &
brain)
EGG
Acid Fast Non – Acid Fast
Taenia asiatica Taenia specie D.H I.H Organ Disease
- 3rd species, closely related to T. saginata affected
Morphology T. saginata Man Cattle Intestine Intestinal
Infective stage: Cysticercus viscerotropica (has wart like, protruberances on external taeniasis
surface and has armed scolex (vestigial hooklets), seen in liver of I.H such as pigs, T. solium Man Pig Intestine Intestinal
cattle, goats, wild boars and monkey taeiniasis
Adult: Scolex is devoid of hooklets but has prominent rostellum T. solium Man Man Muscle, CNS Cysticercosis
and eye
Proglottids: 11-32 lateral branches, has vaginal sphincter
T. saginata Man Pig Liver Intestinal
asiatica taeiniasis
Taenia multiceps (multiceps multiceps)
T. multiceps Dog Sheep and CNS Coenurosis
Adult worm: 40-60 um
rarely man
Scolex: pear shaped w/four suckers and armed
Rostellum: with2 rows of hooklets
Larva (coenurus): characterized by uniocular cyst w/multiceps scolices

Pathogenesis
 Gid/unstable gait or giddiness occurs mainly in sheep (I.H) and other
herbivores affecting CNS
 MOT: ingestion of food and water contaminated with dog’s feces containing
egg

Taenia taeniaformis
 Common intestinal tapeworms of cats
 I.H: rabbits
 I.S of I.H: embryonated eggs
 I.S of D.H: Strobilocercus larva
 D.S: Strobilocercus larva

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