TAENIASIS

An infestation caused by Taenia (Taenia saginata (from undercooked beef), Taenia solium (from undercooked pork), Diphyllobothrium latum (from undercooked fish).

Cause

  • Adult Tapeworms: intestinal infestation, by ingestion of undercooked meat containing cysticerci (larval form of the worm)
  • Larvae forms (cysticercosis): by ingestion of food/water contaminated by eggs of T.solium. The eggs hatch in the intestine, the embryos invade the intestinal walls and disseminate in the brain, muscles or other organs

Clinical features

T. saginata, T.solium (adult tapeworm)

  • Usually asymptomatic, but live segments may be passed
  • Epigastric pain, diarrhoea, sometimes weight loss

Cysticercosis

  • Muscular: muscle pains, weakness, fever, subcutaneous nodules
  • Neurocysticercosis: headache, convulsions, coma, meningo-encephalitis, epilepsy
  • Ocular: exophthalmia, strabismus, iritis

D. latum

  • Usually asymptomatic, but mild symptoms may occur
  • Megaloblastic anaemia may occur as a rare complication

Differential diagnosis

  • Other intestinal worm infestations

Investigations

  • Laboratory: eggs, worm segments in stool or collected from perianal skin (scotch tape method)
  • Cysticercosis: hypereosinophilia in blood and CSF

Management

Tapeworm

  • Praziquantel 5-10 mg/kg single dose
    Alternative
  • Niclosamide
    Adult and child > 6 years: 2 g single dose
    Child < 2 years: 500 mg
    Child 2-6 years: 1 g

    • Give Bisacodyl 2 hours after the dose
      Cysticercosis
  • Refer to specialised facilties
  • Antiparasitic treatment without diagnosis of location by CT or MRI scan can worsen symptoms, and even threaten the life of the patient.
  • Neurosurgical treatment required

Prevention

  • Cook all fish and meat thorougly
  • Proper hygiene: handwashing, nail cutting, proper disposal
    of faeces