Taenia saginata

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Taenia saginata
tapeworm

• T. Saginata( beef ),
• It is common , where undercooked
• beef is eaten.
• The adult worm causes few if any symptoms.
• Infection is usually discovered when proglottids
  are found in faeces or on underclothing
• anxiety.,
• Ova may also be seen on stool microscopy.
  cleared with a single dose of praziquantel (10
  mg/kg).
• It can be prevented by careful meat inspection,
  or by thorough cooking of beef

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Taenia solium cysticercosis

• T. solium, ( pork ), is smaller than T. S.
• acquired by eating uncooked pork. usually
  asymptomatic
• R/
• praziquantel or niclosamide.
• a purgative, as was previously believed

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Cysticercosis,
penetrate the intestinal wall
ingestion of eggs
larvae are liberated

various body parts
These are cysts, 0.51 cm in diameter,
containing the scolex of a new adult worm.
Common sites for cysticerciinclude subcutaneous
tissue, skeletal muscle and brain.
cysticerci.
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symptoms

• Superficial cysts may be felt under the skin,
  no significant symptoms.
• Cysts in the brain
• epilepsy,
• personality change,
• hydrocephalus and focal neurological signs
• These may only appear many years after infection.
  
• diagnosis
• Muscle cysts tend to calcify, and are often
  visible on Xrays.
• Cutaneous cysts can be excised and examined.
• Brain cysts are less prone to calcification, and
  are often only seen on CT or MRI scan
• . Serological tests may support .

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Treatment cerebral cysticercosis

• .
• Albendazole 15 mg/kg daily for 820 days is the
  drug of choice
• the alternative is
• praziquantel 50 mg/kg daily (in divided doses)
  for 15 days.
• due increased local inflammation,
• corticosteroids should be given during after
  the course of anthelminthic
• .
• Anticonvulsants in epilepsy
• surgery may be indicated in hydrocephalus.

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STRONGYLOIDIASIS

• Strongyloides stercoralis is a very small
  nematode which parasitises the mucosa of the
  upper small intestine, often in large numbers,
  causing persistent eosinophilia.
• burrow into the intestinal mucosa and submucosa.
  
• autoinfection and persistent infection.
• infection persisting for more than 35 years
  have been described
• occurs in the tropics and subtropics and is
  especially prevalent in the Far East.

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CLINICAL FEATURES

• Penetration of skin by infective larvae
• Itchy rash
• gut
• Abdominal pain, diarrhoea, steatorrhoea, weight
  loss
• Allergic phenomena
• Urticarial plaques and papules, wheezing,
  arthralgia
• Autoinfection
• Transient itchy linear urticarial weals across
  abdomen and buttocks (larva currens)
• Systemic (super)infection
• Diarrhoea, pneumonia, meningoencephalitis, death

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Investigations Management

• 1. eosinophilia.
• 2. faeces examined microscopically for motile
  larvae(repeted).
• 3. jejunal aspirate to detected Larvae .
• 4. Serology (ELISA) is helpful,
• definitive diagnosis depends upon finding the
  larvae.
• Larvae may also be cultured from faeces.
• R/
• Ivermectin 200 µg/kg as a single dose, or two
  doses of 200 µg/kg on successive days
• Albendazole is given orally in a dose of 15
  mg/kg 12- h 3 days. A second course may be
  required.
• For the Strongyloides hyperinfestation syndrome,
  ivermectin is given at 200 µg/kg on days 1, 2, 15
  and 16.

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ASCARIS LUMBRICOIDES (ROUNDWORM)

• nematode is 20-35 cm long.
• eating food contaminated with mature ova.
• Ascaris larvae hatch in the duodenum, migrate
  through the lungs, ascend the bronchial tree, are
  swallowed and mature in the small intestine.
• This tissue migration can provoke both local and
  general hypersensitivity reactions with
  pneumonitis, eosinophilic granulomas, bronchial
  asthma and urticaria.

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Clinical features

• Intestinal ascariasis
• occasional vague abdominal pain through to
  malnutrition.
• obstructive complications.
• In endemic areas ascariasis causes up to 35 of
  all intestinal obstructions, most commonly in the
  terminal ileum.
• Obstruction can be complicated further by
  intussusception, volvulus, haemorrhagic
  infarction and perforation.
• Other blockage of the
• 1.bile
• 2. pancreatic duct
• 3. obstruction of the appendix by adult worms.

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Investigations Management

• 1. microscopically by finding ova in the faeces.
  
• 2.Adult worms are frequently expelled rectally or
  orally.
• radiographically by a barium examination.
• 3. eosinophilia.
• R/
• Mebendazole 100 mg 12-hourly for 3 days,
• albendazole 400 mg or piperazine 4 g as a single
  dose is effective for intestinal ascariasis.
• Obstruction due to ascariasis should be treated
  with nasogastric suction, piperazine and
  intravenous fluids.

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ANCYLOSTOMIASIS (HOOKWORM)

• Ancylostomiasis
• is caused by parasitisation of the small
  intestine with Ancylostoma duodenale or
• Necator americanus.
• main causes of anaemia in the tropics.

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anemia

• The mean daily loss of blood from one
• A. duodenale is 0.15 ml
• N. americanus 0.03 ml.
• The degree of iron and protein deficiency
  depends not only on the load of worms but also on
  the nutrition of the patient and especially on
  the iron stores.
• In a light infection there may be no anaemia.

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Clinical features

• Dermatitis, usually on the feet (ground itch),
  at the time of infection.
• lungs
• a paroxysmal cough with blood-stained sputum,
• patchy pulmonary consolidation.in cxR
• small intestine,
• vomiting and epigastric pain .
• Sometimes frequent loose stools are passed.
• Iron deficiency anaemia,
• protein-losing enteropathy and hypoproteinaemia
  may develop in the undernourished.
• High-output cardiac failure
• The mental and physical development of children
  may be retarded.
• A well-nourished person with a light infection
  may be asymptomatic.

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Investigations Management

• There is eosinophilia.
• ovum can be recognised in the stool.
• faecal occult blood testing will be positive
• R/
• Mebendazole 100 mg 12-hourly for 3 days is
  preferred,
• single-dose albendazole (400 mg) is the best
  choice.
• Anaemia responds well to oral iron.
• The management of anaemic heart disease is best
  accomplished by treatment with anthelmintics and
  iron.

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TRICHIURA (WHIPWORM) TRICHURIS
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ENTEROBIUS VERMICULARIS (THREADWORM