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Chapter 13 : Intestinal Cestodes

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Abstract:

Cestodes have complex life cycles that usually involve both the intermediate and definitive hosts. In some infections, humans serve as only the definitive hosts, with the adult worm in the intestine (, , , and ). In other cases, humans can serve as both the definitive and intermediate hosts ( and ). About 40% of patients infected with have reduced vitamin B levels, but fewer than 2% develop anemia. The use of both praziquantel and niclosamide has been recommended. A single dose of praziquantel (5 to 10 mg/kg of body weight) both adults and children eliminates the infection in 90% of patients. Cysticercosis infections with larvae are relatively common in certain parts of the world. The presence of cysticerci in the brain represents the most frequent parasitic infection of the human nervous system and the most common cause of adult-onset epilepsy throughout the world. For a number of reasons, is a candidate for control: (i) neurocysticercosis has a tremendous impact on human health; (ii) since is the only source of cysticercosis for both humans and pigs, it may be epidemiologically controllable; (iii) effective and practical therapeutic intervention is available; (iv) international commitment to the use of control measures is present; and (v) the cost is acceptable. The chapter talks about , , , , and .

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13

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Figures

Image of Algorithm 13.1
Algorithm 13.1

, and

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.1
Figure 13.1

Life cycle of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.2
Figure 13.2

Scolex of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.3
Figure 13.3

Gravid proglottids. ( ) ; ( ) ; ( ) ; ( )

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.4
Figure 13.4

Gravid proglottids of (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Slides from J. F. Mueller.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.5
Figure 13.5

eggs. Note the small knob at the abopercular end (end opposite the operculum); also note that the operculum does not fit into “shoulders” like the eggs but presents a smooth outline on the egg shell.

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.6
Figure 13.6

Copepod. (Illustration by Sharon Belkin.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.7
Figure 13.7

, encysted pleurocercoids in cherry salmon fillet. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of T. Oshima, Yokohama City University.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.8
Figure 13.8

Life cycle of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.9
Figure 13.9

(A) Cysticerci in muscle (pork). (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.) (B) Cysticerci in muscle (dog). (Courtesy of W. Jann Brown and Marietta Voge, University of California, Los Angeles.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.10
Figure 13.10

Scolex of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.11
Figure 13.11

Gravid proglottid of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.12
Figure 13.12

eggs. Note the striated shell and the presence of the six-hooked oncosphere within the thick egg shell. The hooks may not be visible in every egg, particularly in specimens that have been stored for long periods in preservatives; however, in clinical specimens submitted to the laboratory in fixatives for timely examination, the hooklets are generally visible within the egg shell. Without special staining, the eggs of spp. cannot be identified to the species level ().

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.13
Figure 13.13

(A) Cysticercus with head invaginated into the bladder. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.) (B) Scanning electron micrograph of scolex from cysticercus. (Photograph courtesy of U.S. Department of Agriculture).

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.14
Figure 13.14

Gross specimen of brain containing many cysticerci. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.15
Figure 13.15

Cysticercus in the eye. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of R. Delgado y Garnica, Hospital Infantil de Tacubaya, Arq. Carlos Laxo y Gaviota, Mexico D.F.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.16
Figure 13.16

Racemose form of cysticercus, left temporal lobe (filmy, white material). (Courtesy of W. Jann Brown and Marietta Voge, University of California, Los Angeles.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.17
Figure 13.17

Section of proliferating bladder wall of racemose cysticercus, demonstrating multiple layers. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.18
Figure 13.18

Calcified cysticerci in tissue. (Armed Forces Institute of Pathology photograph.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.19
Figure 13.19

Neurocysticercosis. Scanning images of cysticerci in brain. (Upper, adapted from the Public Health Image Library, Centers for Disease Control and Prevention; lower, from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.20
Figure 13.20

Life cycle of The same life cycle is applicable to (except that the eggs are contained primarily in the liver of the pig).

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.21
Figure 13.21

Scolex of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.22
Figure 13.22

Gravid proglottid of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.23
Figure 13.23

(). (Left) Scolex (unarmed, no hooks) from cysticercus; (right) scolex from adult worm. (Photographs courtesy of Ping-Chin Fan, with permission.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.24
Figure 13.24

(). (Upper) Gravid proglottid. (Lower) Gravid proglottid (note the large number of uterine branches and the similarity of this proglottid to the one of in Figure 13.22 ). (Photographs courtesy of Ping-Chin Fan, with permission.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.25
Figure 13.25

(). Cross section of cysticercus. (Photograph courtesy of Ping-Chin Fan, with permission.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.26
Figure 13.26

Life cycle of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.27
Figure 13.27

(Upper) Diagram of both a cysticercoid and adult worm in the small intestine. (Illustration by Sharon Belkin.) (Lower) Cysticercoids of in the villi of the small intestine. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.28
Figure 13.28

(Left) Egg of (note the thin egg shell, the six-hooked oncosphere, and the polar filaments that lie between the oncosphere and egg shell). (Right) Egg of (note the thin egg shell, the six-hooked oncosphere, and the lack of polar filaments.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.29
Figure 13.29

Life cycle of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.30
Figure 13.30

Life cycle of

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.31
Figure 13.31

Proglottids of (Upper) Fresh proglottid that may resemble a cucumber seed (note the shape and light color); when the proglottids dry, they may resemble rice grains. (Lower) Stained proglottid. (Photographs from the Centers for Disease Control and Prevention Program: Laboratory Identification of Parasites of Public Health Concern.)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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Image of Figure 13.32
Figure 13.32

egg packets. (Upper) Diagram showing the packet of -like eggs. (Lower) Egg packet in wet mount preparation.

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
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References

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Tables

Generic image for table
Table 13.1

Cestode parasites (intestinal)

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13
Generic image for table
Table 13.2

Classification of neurocysticercosis

Citation: Garcia L. 2007. Intestinal Cestodes, p 357-380. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch13

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