elo173 slide taeniasis

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TAENIASIS

dr.

dr. Hemma

Hemma Yulfi

Yulfi

Departemen

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Clinical Case

Anda adalah dokter yang bertugas di di salah

satu Puskesmas di Kabupaten Samosir. Suatu

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

sering mendapati sepotong benda berukuran

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

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Learning Issues

1. Agent(s) of the disease

2. Nature of the disease

3. Risk factors 3. Risk factors

4. Complications

5. Management: diagnosis, treatment,

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Cestodes

(tapeworm)

General Morphology &

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Morphology

•• TapeTape--likelike •• SegmentedSegmented

•• Scolex (head)Scolex (head)11

•• Strobila, divided into proglottids Strobila, divided into proglottids (segments): (segments): 1 1 2 2 3 3 (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

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Taenia

Taenia sp.

sp.

Taenia

Taenia saginatasaginata Taenia

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Taenia saginata

Beef tapeworm

Beef tapeworm

•• Up to 1Up to 1--2k 2k proglottids proglottids •• Gravid Gravid

segments segments segments segments

crawl out from crawl out from anus

anus

voluntarily voluntarily

•• HabitatHabitat: small : small intestine

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Taenia saginata

Life cycle

Life cycle

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

•• Route of infection: Route of infection: ingestioningestion

•• DxDx stage: stage:

–

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

–

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Taenia saginata

Morphology

Morphology

•• ScolexScolex: 4 suckers : 4 suckers •• Gravid segment: Gravid segment:

–

– 1515--20 branches of 20 branches of uterus

uterusAA

–

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

– 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: hexacanthhexacanth embryo (

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Taenia solium

Life cycle

Life cycle

•• Infective stage: Infective stage:

cysticercus

cysticercus cellulose in pork and or eggscellulose in pork and or eggs

•• Route of infection: Route of infection: ingestioningestion •• Route of infection: Route of infection: ingestioningestion

•• DxDx stage: stage:

-- eggs in feces or swabeggs in feces or swab

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Taenia saginata

Larva

Larva

•• Called Called cysticercuscysticercus bovis

bovis, no hooks, no hooks

•• InvaginateInvaginate in cattle in cattle muscles and tissues muscles and tissues

•• Ingested by human, Ingested by human, evaginate

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Taenia solium

Scolex

Scolex

•• ScolexScolex: 4 suckers, : 4 suckers, hooks,

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Taenia solium

Eggs

•• Resembles the Resembles the eggs of

eggs of Taenia Taenia saginata

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Taenia

Taenia solium

solium

Strobila

Strobila

• Strobila:

– 2-3 m long

– less than 1k proglottids

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Taenia solium

Larva

Larva

•• Called Called cysticercuscysticercus cellulose

cellulose, six hooked, six hooked •• Habitat:Habitat:

–

– human’s muscles and human’s muscles and tissues

tissues tissues tissues –

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Taenia solium

Larva

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Clinical 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.

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Management

• 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

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Management

• 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

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So…

1. Agent(s) of the disease?

2. Nature of the disease?

3. Risk factors?

4. Complications?