Type of cestodes Geog. Dist.

D. Latum Central Europe, Africa, N.America, Far East, Not Egypt Small int of man n fish eating mammals

S. Mansoni Far East, East Africa, North n South America Adults-small int of cats n dogs Plerocercoidamphibians, reptile, birds, man. Resemble D. Latum -shorter Uterus: not rosette shaped, more compact coils. Eggs:resemble D. Latum -smaller -conical operculum

T.Saginata Cosmopolitan, Ethiopia, Mexico, S. America, East n West Africa Small intestine of man.

T. Solium Cosmopolitanuncooked pig Rare in Islamic countries Small intestine of man.

E. Granulosus Cosmopolitan, cattle raising countries Small int of dogs n other carnivorous animal.

H.Nana Cosmopolitan, warm climates

D.Caninum Cosmopolitan

Habitat

Small int of man occasionally rodents

Tapeworm of dogs n cats Man accidentally infected.

Morph.

10 m, 3000-4000 segments Scolex: elongate, soon shaped w 2 long bothria. Mature segments: Broader than long Mid ventral gen.p ore Testes: multiple, dorsolateral Ovary: bilobed, post. V. glands : ventrolat Uterus:rosette shaped, darker, more coiled n packed w eggs Gravid: same morph as mature seg.

Pathogen.

-no of worms -competition for B12 -amount of

-drink water containing Cyclops w procercoid

4-10 m usually 5 m. 1000-2000 proglottids Scolex: Quadrate, Unarmed, 4 hemispherical suckers attach to prox jejunal mucosa. Mature seg: 300-400 testes Blind tubular uterus Bilobed ovary Vagina w term sphincter Gravid: greater no of lat side branches fr central stem Very active, detached singly fr parent worm n creeps out of anus without defecation. Change in motility n secretion of GIT. Reduced gastric secrt.

Differs w t.saginata in: -shorter, 3-8 m n less no f segments (1000) -Scolex: globular w a rosetellum w double rows of hooks -Ovary: trilobed -Gravid uterus; 713 main lat branches on each side.

Minute worm 3 to 6mm Scolex : pyriform w four suckers n 30 t0 36 hooks Neck: short Three proglottids Gravid: length of worm. Uterus : burst b4 evacuation of gravid

Smallest tape worm. Scolex: rhomboidal, 4 suckers, short rosetellum w 2030 spines in single row. Neck: long n slender , 100 segments, broader than long Mature: 3 globular testes in 1 line. Small lobed ovary, vit glands at the middle. Gravid: a sac like uterus w 80-100 eggs. Rupture liberating eggs in int.

Scolex; small rhomboidal, 4 deep cup shaped oval suckers, rosetellum w 7 rows of rose horn hooks. Neck: long n slender. Mature n gravid: longer than broad. Mature: double set of rep organ, 2 marginal gen pores on both sides, horse shoe shaped ovaries,vit glands dital to it. Gravid: longer than mature, net like uterus containing egg capsules each have 520 eggs

Slight irritation at the site of attachment Rare int

Well tolerated in large no. -allergic

Depends on no of worm. Mild symptomps: int disturb., indigestion,

metabolic by products absorbed by host

Clinical pic.

Asymptomatic. Diarrhea, abd pain, pernicious anemia, Intestinal obstruction.

Diagnosis

Eggs or segments in faeces

-eating raw tissues of frogs n snakes contain plerocercoid -apply ing frog tissues contain plerocercoid on inflamed tissue -site of the larvae Sub. Sparga.: Cyst like, itchy, migratory nosule, tender or not -peri. Eosinophilia ocular sparga: oedematous, itchy, painful w excs lacrimation, subconjunctival -retrobulbar: exopthalmus, corneal ulceration. Surgical removal n histopathoexam

obstruction

appetite loss.

Abd pain, nausea, inc or dec appetite/wght -Abd discomfort due to act crawling of gravid Complications: Worm-int obstr. Appendicitis n cholangitis.

-Abd discomfort, hunger pains, diarrhea, alt w constipation n loss of appetite.

Usually asymptomatic -headache, dizziness, anorexia, periodic pain n abd pain.

Treat.

Niclosamide:single dose (4 tablets) PZQ:10mg/kg

Prevent n control

-cooking of fish -freezing for 24 to 48 hrs at 18C -treat inf. Patients -res host: dogs n cats dewormed periodically.

-Surgical removal -Inj ethyl alcohol w procaine in ocular sparga. -PZQ if inoperable -drinking h20 w suspected Cyclops must b filtered or boiled -x use as poultices -x eat raw tissues

Most difficult to diagnose in first 3 mnths. -Gravid seg in faeces Niclosamide PZQ

-stool- gravid segments

Eggs in stool

Gravid in stool Rarely egg capsules

Niclosamide PZQ

Niclosamide (57D)-adult worm PZQ- cysticercoids n adult

PZQ

X eat raw/undercooked beef -carcasses w int cysticerci condemned/boiled. Light inf-freexe at -

-Periodic deworming of cats n dogs. -Dusting of dogs w insecticides to kill fleas.

of snakes n frogs

18C for 5 days Early detect n treat.

LIFE CYCLE D. LATUM Eggs : -faeces of inf person Immature, ovoid, operculated, yellowish brown, 65x45 u. -reach fresh water -mature: 2 weeks -liberate coracidium S. MANSONI Eggs : -faeces of of cats n dogs -water hatch T.SAGINATA Eggs: -mature T.SOLIUM Gravid segments: Pass w defecation on soils E.GRANULOSUS Eggs: Faeces of dogs H.NANA ,Eggs : infective 2 thin shells, inner shell has two knobs w arise 4-8 filaments -man inf by ingestion or autoinfection. -oncospheres hatch in stomach or small int, penetrate the villi n metamorphose into cysticercoids Migrate into lumen of int, attach to mucosa n mature 1st int host: Cyclops 1st int host: Cattle -on reaching duodenum oncosphere hatch n penetrate int wall to mesenteric venules then lymph, gen circ to the muscle. Cysticercus Bovis 1st int host: Pigs n hogs -eggs pass to duodenum or jejunum Int juice n gastric juice disintegrates the eggs -oncosphere penetrate int wall to mesenteric venules n troughout the bosy. -filtered between muscles -Cyst Cellulosae 1st int host: Sheep, cattle, camel, horses, goats, oxen, hogs n accidentally by man -hatch in duodenuoncosphere penetrates int wall, mesenteric venules, lodged in various organ. Hydatid cyst -Bone: no capsule, confined by dense osseous tissue, 1st int host: Fleas n floor beetles -larvae ingest eggs cysticercoid 1st int host: Ctenocephalides canis or c.felis (cat n dog fleas in larval stage) Pulex irritans( human) -oncosphere hatch n penetrate the int of the insects n migrate to their haemocoele n develop into cysticercoids -man infected when ingest insects in D.CANINUM Egg capsules -ingested by larval stages of cat n dogs fleas n human fleas

1st int host: Cyclops within 12 hrs -Penetrate by hook to the body cavity Procercoid larva 2nd int host Fresh water fish -between the muscle Plerocercoid Larvae or Sparganum (inf stage)

2nd int host ; Frogs, lizards, snakes n birds -penetrates int wall n migrates to tissues Plerocercoid Larva *Human Drink h20 containing Cyclops.

Procercoid penetrates int wall n bcomes plerocercoid, released in his int n again migrate to various tissues Def Host: Attach to mucous memb of small int n grow to adult(5-6 weeks) Def host Def host Ingest by cats n dogs Man Adult worm -ingesting inf meat containing cyst bovis(inf stage) -scolex invaginates n fixes to the mucosa n the necks forms segments

*Human -Ingest the eggs n presence of larval stage (cysticercosis)

irregular branching shape, poor laminated layer

food

Def host Man Consume unperfectly cooked pig meat containing cyst (inf stage) -in stomach the cyst wall is digested n the head evaginate upper small int and attached by suckers -adult

Def host: Dogs n carnivores -eat cyst w scolices which develops into adult

Def Host Rodents ingests the insects. Cysticercoids larva attaches to int wall n mature

DISEASES Disease Definition Method of inf Cysticercosis Cond in which the larval stage of T. Soelium cyst. Cellulosae is present in the tissues of man who acts as int host -ingest food or drinks contaminated w eggs -Ext autoinf: He ingests eggs pass in his own faeces -Int autoinfect: reverse peristalsis carry the egg to stomach or duodenum n hatch releasing oncosheres -Gastric juice followed by int juice causes hatching of the eggs -By hooklets n lytic secretions penetrate int wall too mesenteric bv n troughout the body -Subcutaneous tissue n muscle followed by eyes, brain, liver n lungs -develop into Cysticerci -cellular reaction : neutrophils, eosino, lympho. n round cells -fibrous encapsulation Hidatid Disease Presence of larval stage of E. Granulosus in the tissue of man resulting in cystic disease due to unilocular and osseous cyst -ingest eggs of E. Granulosus By: soil, dogs, furs, skeening of foxes In liver (70%), lung (20%), brain, eyes, bone, spleen, spinal cords, kidney Hydatid cyst -surround by fibrous tissue made by immunological response Cyst wall proper -outer milky Non-nucleated laminal layer -innner nucleated laminal layer : a. brood capsule: protoscolices-mature-infective b. daughter cyst: attached or free Hydatid Sand : daughter cyst n free scolices Damage : -mechanical -bones- no capsule : bony invasion n fracture Leakage: allergic manifestations, anaphylactic n scolices disseminate to other organ Clinical pic - No of cysticerci, organs , n viability -subcutaneous tissue n muscle: muscle pain, subcutaneous nodules -brain:epilepsy, focal paralysis, encephalitis n psychic disturb. -eyes: periorbital pain, opacities in the vitreous, glaucoma, blindness -heart: arrythmia n heart block Incubation period: 2 to 20 years b4 signs n symp develop Cyst in liver -painless enlarge. Of abdomen n right hypochondrial pain. Lungs: cough, dyspnea, hemoptysis Eye: Blindness Brain: brain tumor Osseous hydatid cyst: fractures Fate: heales spontaneously, calcified, 2ry inf, metastasis, anaphylactic reaction. -ELISA -Eosinophilia (20 to25%) -Immunoelectrophoresis -Never cyst puncture -Freezing cyst wall -Surgical removal -Abendazole

Pathology n pathogenesis

Diagnosis

Treatment

-biopsy of subcutaneous nodules -x-ray to see calcified lesion in brain n muscle - CSF: Eosinophilia -ELISA -Immunoelectrophoresis -Excision of cysts -PZQ

Prevention

-Corticosteroid -Hospitalization in neurocystocercosis -Niclosamide has no role -Early treat of inf person to reduce autoinf or othr infection -x defecate in soil -inf meat freezed at -15c for 3 days at least -sanitary disposal of human faeces n pig sties far away from houses

-strict personal hygiene -supervise n warns persons working in fur manufactures -control abattoirs Pet n working dogs examined periodically n treated if infected . -kill stray dogs