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2_2018_12_15!09_41_20_AM.pptparaistologi
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- 2. T. saginata T. solium Size 4-8m 2-4 m Scolex 4 suckers, quadrate, no rostellum and hooks 4 suckers, rostellum & hooklets Testes 300-400 150-200 Gravid proglottid: Uterine branches 15-20 7-12 Expulsion of gravid proglottid Expelled singly and may be forced through the anal sphincter Expelled passively in chains of 5 or 6 pro.
- 3. T. saginata T. solium adultlarva D.H Human Human Human I.H Cattle --------- Swine & Human Habitation Small intestine Small intestine Tissue(brain, eye, skin etc.) Infective stage Cysticercus bovis Cysticercus cellulosae Egg Disease Taeniasis Taeniasis Cysticercosis
- 4. Life cycle: Life cycle: Gravid segment migrate from the anus Gravid segment migrate from the anus or pass in the feces. or pass in the feces. Eggs are on the ground, to develop egg Eggs are on the ground, to develop egg must be ingested by pig or man himself. must be ingested by pig or man himself. Hexacanth embryos hatch in the small Hexacanth embryos hatch in the small intestine, migrate through the intestinal intestine, migrate through the intestinal wall and reach the blood & lymphatic wall and reach the blood & lymphatic channels which carry them to skeletal channels which carry them to skeletal muscle & myocardium. muscle & myocardium.
- 5. In 2-3months the embryos transform In 2-3 months the embryos transform into cysticerci into cysticerci. . When When Cysticercus Cysticercus cellulosae cellulosae is ingested is ingested with poorly cooked pig meat (pork), the with poorly cooked pig meat (pork), the larva escapes the cyst and passes to the larva escapes the cyst and passes to the small intestine where it attaches to the small intestine where it attaches to the mucosa by the scolex suckers. mucosa by the scolex suckers. The proglottids develop as the worm The proglottids develop as the worm matures in 3 - 4 months. matures in 3 - 4 months.
- 6. The adultmay live in the small The adult may live in the small intestine as long as 25 years and pass intestine as long as 25 years and pass gravid proglottids with the feces. gravid proglottids with the feces. Eggs extruded from the proglottid Eggs extruded from the proglottid contaminate and persist on vegetation contaminate and persist on vegetation for several days and are consumed by for several days and are consumed by pigs in which they hatch and form pigs in which they hatch and form cysticerci. cysticerci.
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- 8. Life cycle ofTaenia solium
- 10. Pathogenesis & Symptoms Pathogenesis& Symptoms Adult worms do not cause any disturbance, larva Adult worms do not cause any disturbance, larva cause serious trouble. cause serious trouble. Infection with adult Infection with adult T. solium T. solium produce the same produce the same clinical manifestations as clinical manifestations as infection with infection with T. T. saginata saginata (less intestinal obstruction will develop (less intestinal obstruction will develop ? ?). ). Cysticercus cellulosae Cysticercus cellulosae develop in humans following develop in humans following ingestion of eggs in water or vegetables. ingestion of eggs in water or vegetables. Autoinfection and infection of close contacts by Autoinfection and infection of close contacts by finger contamination. finger contamination. Larva can occur in any organ. Larva can occur in any organ. Cysticerci of Cysticerci of T. solium T. solium produce the serious clinical produce the serious clinical consequences. consequences.
- 12. Diagnosis Diagnosis: : Stool examination Stool examination Analswab Anal swab Diagnostic stage: Diagnostic stage: Egg (indistinguishable from egg Egg (indistinguishable from egg of of T. saginata T. saginata & & Echinococcus Echinococcus) ) or gravid proglotids (7-13 arms or gravid proglotids (7-13 arms of uterus). of uterus).
- 13. Treatment: Treatment: Praziquantel Praziquantel 5-10mg/kg single 5-10 mg/kg single dose for children and adults dose for children and adults or or niclosamide are the drug of choice. niclosamide are the drug of choice. Expulsion of scolex must be Expulsion of scolex must be assured to assume a satisfactory assured to assume a satisfactory treatment. treatment. Criteria for cure: Criteria for cure: Recovery of scolex. Recovery of scolex. Negative stool exam 3 months after Negative stool exam 3 months after treatment. treatment.
- 14. Control Control: : Sanitation. Sanitation. Adequatecooking or freezing of pig Adequate cooking or freezing of pig meat or pork are effective precautions. meat or pork are effective precautions. Scientific cattle and pig raising. Scientific cattle and pig raising. Avoid consuming raw meat. Avoid consuming raw meat. Meat inspection. Meat inspection. Periodical deworm. Periodical deworm. Excision of larvae. Excision of larvae. Important to treat persons harboring Important to treat persons harboring adult worm because they can develop adult worm because they can develop cysticercosis due to autoinfection. cysticercosis due to autoinfection.
- 15. Larval tapeworm Larval tapeworm infections infections 1- 1-Cysticercus of Cysticercus of Taenia solium Taenia solium (Cysticercus cellulosae) (Cysticercus cellulosae) Disease: Cysticercosis Disease: Cysticercosis
- 16. Clinical Epidemiology ofCysticercosis: Clinical Epidemiology of Cysticercosis: The larval form of The larval form of T. solium T. solium infects humans infects humans who ingest the eggs of this tapeworm passed who ingest the eggs of this tapeworm passed in human stool. This occurs most frequently in human stool. This occurs most frequently where human stool is used as fertilizer. This where human stool is used as fertilizer. This occurs most frequently in developing occurs most frequently in developing countries where pigs are bred. countries where pigs are bred. Man is the only proven host of the definitive Man is the only proven host of the definitive stage of stage of T. solium T. solium and the pig is the usual and the pig is the usual intermediate host in which the hexacanth intermediate host in which the hexacanth embryo hatched from the egg develops into embryo hatched from the egg develops into the cysticercus or bladder worm. the cysticercus or bladder worm.
- 17. Man is alsoa satisfactory host for Man is also a satisfactory host for larval stage larval stage (cysticercosis). (cysticercosis). Estimated 50 million people with Estimated 50 million people with intestinal taeniasis, world-wide; intestinal taeniasis, world-wide; 20% have cysticercosis; at least half 20% have cysticercosis; at least half will be symptomatic. will be symptomatic. Neurocysticercosis is the most Neurocysticercosis is the most common common parasitic disease of the CNS. parasitic disease of the CNS.
- 18. Morphology: Morphology: Cysticercus larva Cysticercus larva (Cysticercus (Cysticercus cellulosae cellulosae)measured ) measured 5 x 8 – 10 mm. The 5 x 8 – 10 mm. The scolex is deeply scolex is deeply invaginated into the invaginated into the fluid-filled bladder fluid-filled bladder and is provided with and is provided with 4 suckers and 4 suckers and rostellum, as in the rostellum, as in the adult scolex. adult scolex.
- 19. T. solium: Cysticercuscellulosae with invaginated scolex
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- 22. Cysticercus cellulosae Cysticercus cellulosae Itis soybean-like It is soybean-like in shape, with the in shape, with the small scolex invaginated small scolex invaginated into into the translucent cyst. the translucent cyst. The scolex evaginated The scolex evaginated from the cyst . from the cyst . Cysticercius cellulosae
- 23. Pathogenesis & Symptoms: Pathogenesis& Symptoms: The symptoms depend primarily on the The symptoms depend primarily on the tissues in which the embryos become tissues in which the embryos become established and on the number of cysticerci. established and on the number of cysticerci. CNS is the most frequent location for CNS is the most frequent location for cysticerci to develop followed by muscles, cysticerci to develop followed by muscles, subcutaneous tissues, eyes, lungs, heart, subcutaneous tissues, eyes, lungs, heart, liver and other visceral locations. liver and other visceral locations. Infection is more frequently multiple than Infection is more frequently multiple than solitary. solitary.
- 24. Cysticercus mayremains viable in man up to Cysticercus may remains viable in man up to 4-5 years. 4-5 years. Racemosus type: is an unencapsulated larva Racemosus type: is an unencapsulated larva that develops in the subarachnoid spaces at that develops in the subarachnoid spaces at the base of the brain. It may reach in length the base of the brain. It may reach in length to 15 cm. and it produces numerous to 15 cm. and it produces numerous branches. branches. Cysticerci that develop in the subcutaneous Cysticerci that develop in the subcutaneous and muscle tissue cause no pain, in the brain, and muscle tissue cause no pain, in the brain, Cysticerci are commonly found in meninges, Cysticerci are commonly found in meninges, in brain parenchyma. They often occur in in brain parenchyma. They often occur in multiple location. multiple location. Clinical aspects: headache, dizziness, Clinical aspects: headache, dizziness, epilepsy, blurred vision, subcutaneous nodule epilepsy, blurred vision, subcutaneous nodule ……etc. ……etc.
- 25. Immuno-modulation Immuno-modulation Protease inhibitor. Proteaseinhibitor. Inhibits complement. Inhibits complement. Degrade Interleukin-12, Degrade Interleukin-12, immunoglobulins and interferon. immunoglobulins and interferon.
- 26. Some Helminthes Affecting theCNS Disease Agent Predominant Tissues Cysticercosis Taenia solium (pork tape worm) Muscle and brain Hydatid Disease Echinococcus species Liver (75%) and lungs (15%) Schistosomiasis Schistosoma species Liver or bladder Paragonimiasis Paragonimus Lungs Angiostrongylus cantonensis (rat lung worm) Lungs Eosinophilic Meningitis Gnathostoma spinigerum Various organs
- 27. cysticercus containing inverted scolex cerebralcysticercosis
- 28. Cysticercus floating freelyin anterior chamber
- 29. Diagnosis: Diagnosis: x-rays. x-rays. Serologicaltests (IHA & HA). Serological tests (IHA & HA). Biopsy whenever possible (subcutaneous Biopsy whenever possible (subcutaneous cyst). cyst). Computed tomography (CT) for brain cyst. Computed tomography (CT) for brain cyst. MRI (magnetic resonance imaging). MRI (magnetic resonance imaging). Enzyme-linked immunoblot serological test, Enzyme-linked immunoblot serological test, can be as high as 98% sensitive and 100% can be as high as 98% sensitive and 100% specific. specific. Diagnostic stage: Diagnostic stage: Cysticercus Cysticercus larvae. larvae.
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- 31. Control Control: : Prompt treatment ofhumans Prompt treatment of humans infection with the adult worm. infection with the adult worm. Personal hygiene. Personal hygiene. Sanitation. Sanitation. Adequate cooking or freezing of Adequate cooking or freezing of pork. pork.
Editor's Notes
- #8 Life cycle of Taenia solium The life cycle of Taenia solium is similar to that of T. saginata. The adults (length 2 to 7 m; less than 1,000 proglottids, which are less active than in T. saginata, and each with 50,000 eggs; longevity up to 25 years) develop not only in humans but also some other animal species (monkeys, hamsters). The cysticercus develops not only in striated muscle, but also in the brain, liver, and other tissues of pigs and other animals, including humans. Humans develop taeniasis when they ingest undercooked pork meat containing cysticerci. They develop cysticercosis by ingesting T. solium eggs, either by ingestion of fecally contaminated food, or by autoinfection. In the latter case, a human infected with adult T. solium ingests eggs produced by that tapeworm, either through fecal contamination or, more arguably, from proglottids carried into the stomach by reverse peristalsis. http://www.dpd.cdc.gov/DPDx/HTML/ImageLibrary/S_Listing_il.htm
- #19 T.solium: cysticercus cellulosae with invaginated scolex 来源 http://www.cdfound.to.it/html/taen1.htm Courtesy of Dr. Dan Steriu. Head of Parasitology Laboratory, Cantacuzino Institute Spl. Independentei. 103 sect. 5 Bucuresti 70 100, Romania.