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Tapeworm is so called because of the flat and elongated body. It belongs to the class cestoda. Diseases caused in man by these worms are Taeniasis, Hymenolepiasis and Echinococcosis.
Taeniasis is caused by two types of worms-Taenia solium and Taenia saginata also called as pork and beef tapeworm respectively. The adult worms live in the intestine of man. The body of an adult tape worm consists of a head and body made up of multiple segments called proglottids.
The proglottids near the end of the body break off from the main worm and are passed in stool. They contain many eggs. They disintegrate in the soil and release the eggs. When cattle and pigs swallow the eggs they hatch and release larvae.
The larvae enter the blood stream and reach skeletal muscles and form cysts. When man consumes poorly cooked meat containing these cysts larvae are released and mature into adult worms.
Man can also get infected by consuming food contaminated by eggs without exposure to meat.
The larvae of Taenia solium (not Taenia saginata) released from eggs can get encysted in muscles and brain of man. This condition is called cysticercosis.
Symptoms and signs: Infection may remain asymptomatic for a long time. Some children suffer from nausea, abdominal pain, loss of appetite and diarrhea. Occasionally the proglottids may crawl out of anus. Each proglottid may be 1-2 centimeters in size and white in color.
Cysticercosis: There may be nodules under the skin. Each nodule may be up to 2 centimeters in size. After a long time the nodules may become calcified (calcium deposited in the nodules) and appear as white areas on X ray.
Cysts in brain can cause seizures, headache and hydrocephalus (abnormal amount of cerebrospinal fluid in brain.
The cysts can form in the eyes also causing inflammation and threaten visions.
Laboratory findings: Eggs may be found in feces. Occasionally proglottids may be seen. Eosinophils are increased in cerebrospinal fluid if cysticercosis has affected the brain.
Antibodies may be demonstrated using ELISA technique. Cysts in brain may be seen on CT or MRI scan.
Treatment: Drugs effective in taeniasis are praziquantel 5-10 mg per kg body weight as a single dose and Albendazole.
In cysticercosis Albendazole is given in a dose of 15mg/kg in three divided doses for 8 days. It there are cysts in the brain treatment may cause temporary worsening of symptoms because killed larvae evoke inflammatory reaction. In such a situation a short course of Dexamethasone may be required.
Anticonvulsants may be needed for seizures.
Prevention: Proper cooking of meat, thorough washing of vegetables and fruits, and proper disposal of excreta help in prevention.
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