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Maricelle D. Manlutac, RMT, MPH, MLS(ASCPi)

Cestodes/ Tapeworms
 Fresh living worms: white and yellowish in color

 Adult: Flat and ribbon-like

Cestode body consist of:

1. Scolex

2. Neck

3. Proglottids / Strobila
a. Immature segment
b. Mature
c. Ripe/ Gravid
Order Pseudophyllidea Order Cyclophyllidea
 Diphyllobothrium latum  Species which require
vertebrate IH

 Species which require

invertebrate IH

 Species which may or may not

require IH
Point of Differentiation
Pseudophyllidean Cyclophyllidean

 Scolex Spoon-shaped with slit like Quadrate with four

sucking grooves, no hooklets cuplike suckers
 Strobila Anapolytic Apolytic

 Ova Oval, operculated, immature Spherical, non-operculated,


 IH 2 IH 1 IH

 Larva Coracidium Cysticercoid

Procercoid Cysticercus

Plerocercoid Hydatid
Diphyllobothrium latum
 CN: Broad or Fish Tapeworm

 Largest tapeworm of man

 Scolex: spatulate/ spoon-shaped/ almond shaped with sucking organ

 Uterus: Rosette formation

 1st IH: Crustaceaen/ Copepods

 2nd IH: Fresh water fish

 MOT: ingestion with PLEROCERCOID larva

 Pathology: Tapeworm anemia/ Vitamin B12 deficiency anemia

Diphyllobothrium latum

 Yellowish brown with

thick shell

 58 to 76µm by 40 to
51 µm

 Operculated with tiny

knob-like abopercular
Diphyllobothrium latum
Lab Dx
 DFS- eggs (no segment/ proglottid)

 Kato techniques

 Diphyllobothriasis VS PA (achlorhydria)

Treatment: Praziquantel
Taenia saginata Taenia solium

 CN Beef Tapeworm Pork Tapeworm

 IH Cattle Pig (“measly pork”)

 Scolex None, no rostellar hooks With rostellum armed

with 2 rows of large and
small hooklets

 Length 25 meters 7 meters

 # Proglottids 1000-2000 Less than 1000

 Gravid 15-20 lateral branhes 7-13 lateral branches

proglottid (Dichotomous/ Tree like) (Dendritic or fingerlike)
Taenia saginata Taenia solium

 Eggs Spherical, striated, inside is an embryo with 6 hooklets


 IS Cysticercus bovis Cysticercus cellulosae

 Mature Vaginal sphincter accessory ovarian lobe


 Pathology Taeniasis saginata Taeniasis solium/

Taenia spp. Egg

 30 to 45 µm

 Thick brown striated


 Hexacanth embryo
Taenia saginata
Taenia solium
Taenia solium
Taenia solium
Cysticercus cellulosae
Lab Dx
 DFS – proglottids, eggs, or scolex

 Perianal swab


 Neurocysticercosis – CSF protein and glucose, CT SCAN, and MRI

 Opthalmic cysticercosis – ophthalmoscopy


 Nonspecific abdominal complaints

 Cysticercosis – striated muscles, brain, and subcutaneous tissues

 Intraorbital pain and blurring of vision

Treatment: Praziquantel and Niclosamide

Taenia asiatica

 Often misidentified as Taenia saginata

 Present in the liver of IH : Cysticercus viscerotropica

 Scolex is devoid with hooklets

 11 to 32 lateral branches
Hymenolepis nana Hymenolepis diminuta

 CN Dwarf tapeworm Rat tapeworm

 Scolex With rostellum armed With an unarmed rostellum

with a ring of 20-30 spines

Y-shaped hooklets

 Eggs Eggs contain an oncosphere enclosed in an inner

membrane with two polar thickenings

**With 4-8 polar filaments **Without Filaments

 IS Direct: Egg Cysticercoid larva

Indirect: cysticercoid larva

 FH Man Rat

Hymenolepis nana Hymenolepis diminuta


Hymenolepis nana Hymenolepis diminuta


Hymenolepis nana Hymenolepis diminuta

Lab Dx
 DFS- eggs, scolex but not proglottids


 Praziquantel
Dipylidium caninum

 Dog tapeworm / double-pored tapeworm / pumpkin seed tapeworm

 Proglottids have double set of reproductive organs and genital pore on
each side of the lateral margin
 Mature and gravid proglottid: Melon seeds/pumpkin seeds/ rice grains
 IH: Cat flea (Ctenocephalides canis)
Dog flea (Ctenocephalides felis)
Dog louse (Trichodectes canis)
Human flea (Pulex irritans)
 IS: Cysticercoid larva
Dipylidium caninum

 Egg in pockets

 8 to 15 eggs enclosed in
embryonic membrane

 Thin shelled with hexacanth

Dipylidium caninum
 Pale reddish adult

 10 to 70 cm

 Thorn shaped hooklets ( 1 to 7


 Bilateral genital pores

 Pumpkin seeds gravid proglottid

Raillietina garrisoni

 60 cm with four acetabula

 90 to 140 Hammer-shaped hooks

 Spindle shaped eggs

 Grains of rice segements- motile

 IH: Flour beetle

 Lab Dx: DFS by identification of eggs and proglottid

 Treatment: Praziquantel
Flour Beetle (Tribolium spp.)
Raillietina garrisoni
Echinococcus granulosus

 Hydatid worm producing hydatid disease

 Shortest tapeworm with only three


 Eggs cannot be differentiated from eggs

of Taenia

 IS: Hydatid Cyst

 FH: Dog
Lab Dx
a. Exploratory cyst puncture

b. Roentgenogram (x-ray)

c. Immunologic test – Bentonite Flocculation test

Casoni: intradermal test

d. Serologic tests

Pathology: Extraintestinal Disease (Cystic Echinococcosis)

Treatment: Surgical resection, PAIR, Mebendazole or albendazole

Echinococcus granulosus:
Hydatid cyst
Echinococcus granulosus
Prominent scolex