TAENIASIS - ocw.usu.ac.idocw.usu.ac.id/.../elo173_slide_taeniasis.pdf · Microsoft PowerPoint - Taeniasis.ppt [Read-Only] [Compatibility Mode] Author: dewi Created Date: 8/27/2010

TAENIASISTAENIASIS

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dr. dr. HemmaHemma YulfiYulfi

DepartemenDepartemen ParasitologiParasitologi

Clinical CaseClinical Case

Anda adalah dokter yang bertugas di di salah

satu Puskesmas di Kabupaten Samosir. Suatu

kali seorang pasien lelaki 40 tahun mengeluhkali seorang pasien lelaki 40 tahun mengeluh

sering mendapati sepotong benda berukuran

sekitar 1x0.5cm bewarna putih susu, kenyal dan

bergerak aktif di dalam celana dalamnya.

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Learning IssuesLearning Issues

1. Agent(s) of the disease

2. Nature of the disease

3. Risk factors3. Risk factors

4. Complications

5. Management: diagnosis, treatment,

prevention

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CestodesCestodes(tapeworm)(tapeworm)

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General Morphology & General Morphology &

Classification Classification

MorphologyMorphology

•• TapeTape--likelike

•• SegmentedSegmented

•• Scolex (head)Scolex (head)11

•• Strobila, divided into proglottids Strobila, divided into proglottids (segments):(segments):

11

22

33

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(segments):(segments):–– Immature proglottidsImmature proglottids22

–– Mature proglottidsMature proglottids33

–– Gravid proglottidsGravid proglottids44

•• HermaphroditeHermaphrodite

•• Hooks and suckersHooks and suckers

•• GIT: nilGIT: nil

•• Body cavity absentBody cavity absent

44

Classification Classification

�� Intestinal cestodes:Intestinal cestodes:�� Taenia saginataTaenia saginata

�� Taenia soliumTaenia solium

�� Hymenolepis nanaHymenolepis nana

�� Hymenolepis diminutaHymenolepis diminuta

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�� Hymenolepis diminutaHymenolepis diminuta

�� DiphyllobothriidaeDiphyllobothriidae

�� Zoonotic cestodes:Zoonotic cestodes:�� Echinococcus granulosusEchinococcus granulosus

�� Dypilidium caninumDypilidium caninum

TaeniaTaenia sp.sp.

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TaeniaTaenia saginatasaginata

TaeniaTaenia soliumsolium

Taenia saginataTaenia saginataBeef tapewormBeef tapeworm

•• Up to 1Up to 1--2k 2k

proglottidsproglottids

•• Gravid Gravid

segments segments

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segments segments

crawl out from crawl out from

anus anus

voluntarilyvoluntarily

•• HabitatHabitat: small : small

intestineintestine

Taenia saginataTaenia saginataLife cycleLife cycle

•• Infective stageInfective stage: : cysticercuscysticercus bovisbovis in cattle meatin cattle meat

•• Route of infection: Route of infection: ingestioningestion

•• DxDx stage: stage:

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•• DxDx stage: stage:

–– eggs in feces or anal swabeggs in feces or anal swab

–– gravid segmentsgravid segments

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Taenia saginataTaenia saginataMorphologyMorphology

•• ScolexScolex: 4 suckers : 4 suckers

•• Gravid segment: Gravid segment:

–– 1515--20 branches of 20 branches of uterusuterusAA

–– Genital pore: one of Genital pore: one of

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–– Genital pore: one of Genital pore: one of each segment in each segment in irregular irregular sitesiteBB

•• EggEgg (viable up to 159 days)(viable up to 159 days)::

–– EllipticalElliptical

–– EmbryophoreEmbryophore (thick (thick

shell with radial pattern)shell with radial pattern)

–– Content: Content: hexacanthhexacanthembryo (embryo (oncosphereoncosphere))

Taenia soliumTaenia soliumLife cycleLife cycle

•• Infective stage: Infective stage:

cysticercuscysticercus cellulose in pork and or eggscellulose in pork and or eggs

•• Route of infection: Route of infection: ingestioningestion

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•• Route of infection: Route of infection: ingestioningestion

•• DxDx stage: stage:

-- eggs in feces or swabeggs in feces or swab

-- cysticercuscysticercus cellulose from tissue biopsycellulose from tissue biopsy

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Taenia saginataTaenia saginataLarva Larva

•• Called Called cysticercuscysticercus

bovisbovis, no hooks, no hooks

•• InvaginateInvaginate in cattle in cattle

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muscles and tissuesmuscles and tissues

•• Ingested by human, Ingested by human,

evaginateevaginate in small in small

intestine to become intestine to become

adult wormadult worm

Taenia soliumTaenia soliumScolexScolex

•• ScolexScolex: 4 suckers, : 4 suckers,

hooks, hooks, rostellumrostellum

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Taenia soliumTaenia soliumEggs Eggs

•• Resembles the Resembles the

eggs of eggs of Taenia Taenia

saginatasaginata

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TaeniaTaenia soliumsoliumStrobilaStrobila

• Strobila: – 2-3 m long

– less than 1k proglottids

– proglottid: less uterine branches (7-12 pairs)

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Taenia soliumTaenia soliumLarva Larva

•• Called Called cysticercuscysticercus

cellulosecellulose, six hooked, six hooked

•• Habitat:Habitat:–– human’s muscles and human’s muscles and

tissuestissues

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tissuestissues

–– Pig’s muscles and tissuesPig’s muscles and tissues

Taenia soliumTaenia soliumLarva Larva

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Clinical ManifestationsClinical Manifestations

• Taenia solium may cause cysticercosis. The

most severe cysticercosis is that which involve

CNS (neurocysticercosis). Other sites are

lungs, liver, and eyes.

• Neurocysticercosis might cause meningitis,

epilepsy, dementia, and can be fatal.

• Taenia saginata does not cause cysticercosis.

However, the voluntary excretion of the

segments might have the patients

uncomfortable and induce mental depression.

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ManagementManagement

• Diagnosis is based on QDP (questionnaire of

demonstration proglottids). Though possible,

it’s hard to get the eggs from fecal examination.it’s hard to get the eggs from fecal examination.

• Cysticercosis is found through radiologic

examination

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ManagementManagement

• The worms need to be expelled completely from the

intestine. We need to be sure that not only have the

proglottids, but also the scolex and neck been

removed.

• Laxatives to expel proglottids

• Niclosamide

• Praziquantel 40mg/kgBW (single dose)

• Surgery for the csticercosis.HY 22

So…So…

1. Agent(s) of the disease?

2. Nature of the disease?

3. Risk factors?

4. Complications?4. Complications?

5. Management: diagnosis, treatment, prevention?

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