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Taenia solium
- 2. WHERE DOES IT BELONG? order order Phylum Class Order Family Genus species Platyhelminthes( flatworms) Cestoidea Cyclophyllidea Taenidae Taenia solium
- 3. Taenia solium - pork tape worm Taenia - band/tape Worldwide in distribution except in regions and communities who dont consume pork
- 5. Human small intestine, commonly in jejunum
- 7. Parts of adult T.solium rostellum proglottids
- 8. ADULT WORM 2-3 m long Scolex small & globular(1mm) 4 large cup like suckers(acetabula) Rostellum with double row of alternating round & small dagger shaped hooks. (20-50 ) Neck is short and half as thick Proglottids less than 1000
- 9. Gravid segments are twice as long & broad. Testes composed of 150-200 follicles An accessory lobe for ovary Vaginal sphincter absent Uterus has 5 to 10 thick lateral branches A lateral thick lipped genital pore is present alternating the right & left sides of adjacent segments. Gravid segments pass passively out as short chains. Eggs escape from ruptured uterus
- 10. EGGS Egg similar to T.saginata Spherical 30-40 micro.m Thin hyaline membrane around it which disappears after release Inner embryophore radially striated & is yellow brown due to bile staining. In the centre a fully developed embryo(oncosphere) with 3 pairs of hooklets(hexacanth embryo) Eggs do not float in saturated salt solution Eggs are infective both pigs & humans.
- 11. LARVA Larval stage of taenia cysticercus Of T.solium called cysticercus cellulosae
- 12. CYSTICERCUS CELLULOSAE(BLADDERWORM) Infective form Develop in various organs of pig & human Ovoid,opalescent milky-white Measuring 8-10 mm in breadth and 5 mm in length. Scolex of larva with its suckers lie invaginated within the bladder It remains viable for several months.
- 14. When T.solium causes taeniasis Definitive host - man Intermediate host pig Infective stage - larva
- 15. When it causes cysticercosis o Definitive host - man o Intermediate - man o Infective stage- eggs o Mode of infection- by ingesting eggs with contaminated food & water o man harboring adult worm can auto infect himself by unhygeinic habits or reverse peristalsis.
- 16. o Oncospheres released in duodenum or jejunum & penetrate intestinal wall o They enter mesenteric venules & lymphatics o Carried to different parts of body by systemic circulation o Filtered in to muscles & develop in to larval stage in 60-70 days o Larvae die without further development
- 19. Intestinal taeniasis caused by T.solium & T.saginata Sometimes asymptomatic When symptomatic causes abdominal discomfort,indigestion,nausea,diarrhea& weight loss Occasionaly acute appendicitis & pancreatitis
- 20. Cysticercosis Caused by larval stage Larva-solitary or multiple Most common-subcutaneous tissue& muscle Also affect- eyes,brain,heart,liver,lungs,abdominal cavity& spinlcord
- 21. Larvae can evoke a cellular reaction starting with infiltration of neutrophils,eosinophils,lymphocytes,plasma cells & giant cells Subcutaneous asymptomatic Cysticercus surrounded by a fibrous capsule except in eye & ventricles of brain
- 22. CLINICAL FEATURES- Subcutaneous cysticercosis myocysticercosis neurocysticercosis oculocysticercosis
- 23. SUBCUTANEOUS CYSTICERCOSIS Mostly asymptomatic Subcutneous nodules
- 24. MYOCYSTICERCOSIS May cause acute myositis
- 25. NEUROCYSTIERCOSIS Most common & serious Adult onset epilepsy Hydrocephalous Psychiatric disturbances Meningoencephalitis Transient paresis Behavioral disorders Aphasia Visual disturbances Cause intracranial space occupying lesion
- 26. MRI of brain showing neurocysticercosis
- 27. OCULAR CYSTICERCOSIS Cysts found in vitreous humor,subretinal space & Conjunctiva May present as blurred vision or loss of vision Iritis ,uveitis & palpebral conjuctivitis
- 29. TAENIASIS 1. Stool examination Eggs microscopic examination shows eggs Formol ether sedimention of method of stool concentration useful Detected by cellophane swab method Species identification not possible
- 30. Proglottids Species identification possible using hand lens When gravid proglottid pressed between two slides branching can be made out Only 13 lateral branches in T.solium
- 31. Detection of taenia antigen in feces ELISA using polyclonal antisera to detect coproantigen More sensitive than microscopy Cannot differentiate between T.solium T.saginata
- 32. Serodiagnosis specific abs detected by ELISA indirect immunoflouroscent test indirect hemgglutination (IHA) test Molecular diagnosis DNA probes & PCR to detect & differentiate b/n T.solium & T.saginata
- 33. Others Ocular cysticercosis-by opthalmoscopy Eosinophilia in early stage
- 35. Intestinal taeniasis Single dose of praziquantel(10-20 mg) Nicolsamide (2 g) single dose Purgation is not necessary
- 36. Cysticercosis Excision best method Asymptomatic neurocysticercosis no treatment Symptomatic cerebral cysticercosis-praziquantel 50 mg/kg in divided dose for 20-30 days Albentazole 400 mg twice daily for 30 days Corticosteroids to reduce inflammatory reactions Antiepileptic drugs Operative intervention indicated for hydrocephalous
- 38. Inspection for cysticerci in slaughter house Avoid undercooked pork (temp 56 `c for 5 mts) maintain clean personal habits & general Sanitary measures Prevention of fecal contamination Detection & treatment of hosts