H.
nana,
Taenia,
Department of Microbiology
T.N.M.C & BYL Nair Ch. Hospital, Mumbai.
Introduction
Helminths
Classification
◦
Cestodes- tapeworms
◦
Trematodes- flukes
◦
Nematodes- round worm
Enlist intestinal Cestodes
& Nematodes
Cestodes Nematodes
•Ascaris,
• Tinea Saginata
•Hookworm
• Tinea Solium
•Strongyloides
• Hymenolepis
•Trichuris
Nana
•Enterobius.
• E. granulosus
Characters of cestodes &
Nematodes
Platyhelminths Nemathelminths
Cestodes Nematodes
•
Elongated,
Flattened,
Cylindrical
Segmented •
Unsegmented
Tapelike •
Diecious
Monoecious •
Alimentary canal
Alimentary complete
•
Body cavity
canal-
present
incomplete
Body cavity
absent
General characters of
Cestodes
Tapeworms- long,
segmented, flat
Parts:Head (scolex),
neck, strobila
Head (scolex)- Suckers &
Hooks
Strobila-,
PROGLOTTIDES/
SEGMENTS each
containing reproductive
structures with eggs and
General characters of
Cestodes
Monoecious
Body cavity absent
Alimentary canal entirely absent
Excretory & nervous system
present
Developmental stages
CLASSIFICATION OF CESTODES
Intestinal
•Tinea Saginata
•Tinea Solium
•H. Nana
Extra-intestinal
•E. Granulosus- Liver, kidney, brain
•Tinea solium- muscles, brain, eye
TAENIA
SAGINATA
(beef
tapeworm)
Unarmed tapeworm of
man)
MORPHOLOGY – ADULT WORM
5 – 10 metre, may be up to 24 meters
Scolex
• 1 – 2 mm
• Quadrate in outline
• 4 circular suckers
• Not provided with rostellum / hooklets
Moves against peristaltic movements of host
intestine
Neck – long, narrow & fragile
MORPHOLOGY – ADULT WORM
(CTD.)
Proglottides
• 1000 – 2000
• Gravid uterus – central stem with 15 –
30 lateral branches on each side
• Gravid segment – expelled singly
MORPHOLOGY - EGGS
Spherical, Bile stained, 31 – 43 m
Thin outer transparent shell – remnant of yolk
sac – eggs clump
Inner embryophore – brown, thick walled,
radially striated
Contains oncosphere with 3 pair of hooklets
Does not float in sat. solution of common salt
Resistant – remain viable for 8 weeks
Infective only to cattle
MORPHOLOGY: larval
form
Larval form- cysticercus bovis
In cattle
Larval stage in muscles of cattles
5-10X3-4mm
Invaginated scolex
Survive up to 8 months
Pathogenicity &
Pathogenesis of
Cestodes
Attach to intestinal epithelium &
robe nutrients
Abdominal discomfort, indigestion,
diarrhea
Crawlingof proglottides at anus
during daytime
T.soilum-Neurocystecercosis
(Extraintestinal)
LIFE CYCLE OF TAENIA
SAGINATA
2 hosts
Definitive host: Human
Intermediate host: cattle (cow /
buffalo)
Life span- > 10 years
Infective forms:
Encysted larva (cysticercus bovis)
to human
Eggs to cattles
Life cycle in Human
Infective form- cysticercus bovis
Ingestion of undercooked meat –
scolex exvaginate after contact with
bile – strobilization- adult worm – egg
bovis
Life cycle in Cattle
Infective form: embryonated
eggs
Ingestion of eggs/ gravid segments –
alimentary canal egg rupture to
liberate onchosphere – penetrate gut
wall – portal/ mesenteric vessels-
systemic circulation- develop in
muscles tongue, neck, shoulder –
onchosphere forms vesicle –
contains larva (head) – cysticercus
TAENIA SOLIUM
(pork tapeworm)
Armed tapeworm of man)
MORPHOLOGY- Adult worm
2 – 3 meters in length
Scolex
4 circular suckers
Head provide with rostellum &
double rows of hooklets
MORPHOLOGY
Proglottides
• < 1000 (800 – 900)
• Gravid uterus – median
longitudinal – 5 – 10 branches on
each side
• Segments expelled passively in
chains of 5 – 6
MORPHOLOGY - EGGS
Same as of Taenia saginata
Eggs infective to pigs & man
MORPHOLOGY- larval
stage
Cysticercus cellulosae
In muscles of pig/ (Man)
Mature cyst – opalescent
ellipsoidal body 8 – 10 x 5
mm
Long axis in parallel to
muscle fibre
Dense milk white spot at
the side where scolex with
hooks & suckers remains
invaginated
LIFE CYCLE TAENIA
2SOLIUM
hosts
Definitive host- Human
Intermediate host- Pig,
Human also
Life span- 25 years
Pork eaters
Also in humans in contact with
pigs, eating infected vegetables
Epidemiology
Man becomes infected in same way
as pigs
• Drinking contaminated water
• Eating uncooked vegetables
contaminated with eggs
• Auto infection
Unclean / unhygienic habits
Reversal of peristalsis
Pathogenesis of taenia
solium similar to T. saginata
Intestinal
Cysticercus cellulosae (larval
stage)
Develop in any organ & effect
depends on location
Cysticerci – subcutaneous tissue &
muscles causing palpable / visible
nodules
Brain– neurocysticercosis
Eye– opthalmic cysticercosis
Cysticerci have tendency to become
calcified & obsolete in 5 – 6 years
Neurocystecercosis
Serious condition
CYSTICERCUS in the CNS
Epileptic seizures (58-80% when
parenchymal brain cysts).
Intracranial hypertension,
hydrocephalus,
This syndrome is related to the
location of parasites in the
cerebral ventricles or cisterns.
Neurocystecercosis
Laboratory Diagnosis of Tinea
Macroscopic examination of stool –
segments
If specimen collected after antihelminthic –
screened for scolex
Microscopic examination for eggs
◦
Direct
◦
Concentrated stool specimen
◦
Perianal swab
Eosinophilia and elevated levels of serum IgE
may be detected
Diagnosis of cysticercosis
Biopsy of subcutaneous nodule
Diagnosis of cysticercosis
Non-Invasive- CT, MRI
Invasive- Biopsy
TREATMENT &
PROPHYLAXIS
Avoid eating raw / uncooked
meat
Adequate inspection of meat
at slaughter house
Proper sanitary control – prevent
infection of intermediate host
Personal hygiene
Effective treatment of all cases
harboring adult worm
T. SAGINATA T. SOLIUM
LENGTH 5 – 10 meters 2 – 3 meters
HEAD Large quadrate, Small globular
Without rostellum & With rostellum &
hooks, hooks
Suckers may be Suckers not
pigmented pigmented
PROGLOTTID 1000-2000 < 1000
E
EXPULSION Expelled singly Expelled passively in
chains of 5 or 6
UTERUS Lateral branches 15 – 30 Lateral branches 5
on each side – 10 on each side
Thin & dichotomous Thick & dendritic
VAGINA sphincter present sphincter absent
OVARIES 2, no accessory lobe 2, an accessory lobe
TESTES 300 – 400 follicles 150 – 200 follicles
HYMENOLEPS NANA
(Dwarf tapeworm)
Introduction
Smallest (1 – 4 cm x 1 mm)-
(nana- small- dwarf) most common
tapeworm found in human
intestine.
Short life span- 2 weeks
Infection more in school children
and institutional population.
Completes life cycle in one
MORPHOLOGY – ADULT
WORM
Scolex
• 4 suckers with short retractile rostellum
• Armed with single row of hooklets (20 –
30)
tuning fork
Proglottides
• Number – 200
• Mature segment – 0.3 mm x 0.9 mm
MORPHOLOGY – EGGS (CTD.)
Spherical / oval
30 – 45 m
2 distinct membrane
Outer thin & colorless
Inner embryophore – oncosphere with 3 pair of
hooklets
Space between 2 membranes – filled with yolk
granules & polar filaments
Floats in saturated solution of common salt
Life cycle
Only one host Human (both
definitive & intermediate)
? Intermediate host: rat flea
Egg- heaxacanth embryo- small
intestine- cysticercoid (larval
stage) – in intestinal villus –
mature – adult- egg
Life cycle
Laboratory diagnosis
Stool microscopy
Demonstration of eggs
