[PSEUDOPHYLLIDEAN TAPEWORMS 1 (D. LATUM)-DR.

ASUNCION] NOV. 19, 2014 (AM)

T- Taenia species ( example)
A- Adults habitat: small intestine
P- Proglottids contain male and female parts

E- Eggs: 6 hooked embryo (cyclophilidean)

W- Worldwide distribution
O- Zero (No) respiratory, vascular and
digestive system
R- Ribbon like body, flat
M- Middle (intermediate) host required
Intestinal Tapeworms
-

Diphyllobothrium latum
Hymenolepis nana
Hymenolepis diminuta
Dipyllidium caninum
Taenia saginata
Taenia solium

Extraintestinal Tapeworms
-

Sparganosis, cystercercosis
Hydatid cyst disease

A general PE revealed the patient to

be moderately built and dull looking
with a body temp of 38.2 C, a PR of
110 bpm, RR 22 cpm, BP- 110/70
The haematological profile of the
patient showed 9.3 g/dL HGB, RBC
COUNT 2.8 rbc/mm3, HCT- 30.2%,
MCV 107.9 um3/rbc. A MCH volume
33.2 pg, and MCHC 32.47%, no
eosinophilia was observed, and her
erythrocyte sedimentation rate was
found to be 10mm/hour
o MCV Normal- 100: dealing
with larger red cells
(megaloblast) -> megaloblastic
anemia
Secondary to lack of Vit
b12
Stool samples obtained for ova and
cyst examination were sent to the
microbiology laboratory. Macroscopy
of her stool revealed undigested
material that was semiformed but
without any, foul smell. White to
creamish specks were observed in
her stool. A wet mount showed the
presence of operculated eggs

Diphyllobothrium latum
CASE
A 19 y/o student was brought to the ER with
complaints of low grade fever vomiting
and loose stools that had started 3 days
earlier. The vomit was non foul smelling, non
mucoid, non blood streaked, but contained
undigested food particles, the patient also
complained off colicky abdominal pain. Her
loose stools were watery in consistency, non
foul smelling, and contained no blood or
mucus, and the patient showed no signs of
dehydration, she reported no history of
similar complaints or nay previous
hospitalization, she is a pescetarian (fish
and vegetarian).

Disease:
o Diphyllobothriasis, fish tape
worm infection, broad tape
worm infection
Common name:
o Broad fish tapeworm
Definitive host: human, dog, cat
IH
o 1st: Fresh water copepods
Cyclops, Diaptomus
o 2nd: fresh water fishes- Pike
,salmon, trout, whitefish, turbot,
tilapia
EPIDEMIOLOGY
o Seen in temperate zones
o Europe, Asia, South America,
North America, East Africa,
Australia

[PSEUDOPHYLLIDEAN TAPEWORMS 1 (D. LATUM)-DR.

ASUNCION] NOV. 19, 2014 (AM)
Endemicity
Inadequate sewage
disposal, presence of
suitable fresh water
intermediate hosts,
custom of eating raw fish
>3000 proglottids identified
Latum broader than long
Have the ability for self fertilization
HABITAT: ileum, sometime jejunum
LIFE SPAN: 20 years
o

o
o

Coiled and rosette-like- uterus

Produces 1M eggs

ADULT

SCOLEX
o Spatula like
o Suctorial grooves or bothria

GRAVID PROGLOTTID
o Unite at the common genital
pore
o Eggs are discharged at the
uterine pore, seen at the center
of the proglottid
o Bilobed ovary

Yellowish brown in color

Immature when laid
Single shelled with inconspicuous
lid and a knob like end

[PSEUDOPHYLLIDEAN TAPEWORMS 1 (D. LATUM)-DR.

ASUNCION] NOV. 19, 2014 (AM)
o
o
o
o

LIFE CYCLE

o
o
o
o

o
o

Embryonation occurs in water

Release of coracidium and
ingested by 1st IH
Transforms into Procercoid larae
in body cavity of 1st IH
Procercoid released by
crustaciean develops into
plerocercoid larva
Predator fish eats infected small
fish
Human ingests raw or
indercooked infected fish

Adults in ileum or jejunum

Proglottids release immature
30 proglottids per day
Maturity 3-5 weeks after
ingestion
DS unembryonated eggs/
mature or gravid proglottid in
the feces

PATHOLOGY AND
SYMPTOMATOLOGY
o Intestinal obstruction
o No symptoms if only 1 worm
present
o No eosinophilia
o Minor clinical manifestations:
nervous disturbances, loss of
weight, weakness, malnutrition
and anemia ( vit b12 deficiency
associated with D. latum)
Hunger pains, epigastric
fullness, loss of appetits,
anorexia, n/v
Pernicious hyperchromic
anemia (megaloblastic
anemia)
DIAGNOSIS
o Rarely made based on clinical
symptoms
o Important data: residence in
endemic areas, raw fish diet,
pernicious type of anemia
o Laboratory:
Operculated eggs or
proglottids in feces or
vomitus
White specks in
feces
TREATMENT
o DOC: Niclosamide after light
meal
Tends to have to result a
macerated scolex
o Alternative
Paramomycin- may also
cause macerated scolex
but has lighter side
effects
Praziquantel

[PSEUDOPHYLLIDEAN TAPEWORMS 1 (D. LATUM)-DR.

ASUNCION] NOV. 19, 2014 (AM)
Quinacrine HCL
Provide recovery of
the scolex once
expelled
Most severe s/e of
nausea and
vomiting
Most expensive
PREVENTION
o Control the source of infection
Disposal of sewage
Marketing of fish

Proper cooking or
preparation of fish
Freezing may kill
the parasite (-10C)
Thorough cooking
Soaking in a Salted
solution
Public education
--JELICOE