CESTODES: Tapeworms and Their Characteristics

CESTODES
Maricelle D. Manlutac, RMT, MPH, MLS(ASCPi)

Faculty
Cestodes/ Tapeworms
 Fresh living worms: white and yellowish in color
 Adult: Flat and ribbon-like
Cestode body consist of:
1. Scolex
2. Neck
3. Proglottids / Strobila
Types:
a. Immature segment
b. Mature
c. Ripe/ Gravid
Cestodes
Order Pseudophyllidea Order Cyclophyllidea
 Diphyllobothrium latum  Species which require
vertebrate IH
 Species which require

invertebrate IH
 Species which may or may not

require IH
Point of Differentiation
Pseudophyllidean Cyclophyllidean
 Scolex Spoon-shaped with slit like Quadrate with four

sucking grooves, no hooklets cuplike suckers
 Strobila Anapolytic Apolytic
 Ova Oval, operculated, immature Spherical, non-operculated,

mature
 IH 2 IH 1 IH
 Larva Coracidium Cysticercoid

stages
Procercoid Cysticercus
Plerocercoid Hydatid
Diphyllobothrium latum
 CN: Broad or Fish Tapeworm
 Largest tapeworm of man
 Scolex: spatulate/ spoon-shaped/ almond shaped with sucking organ
 Uterus: Rosette formation
 1st IH: Crustaceaen/ Copepods
 2nd IH: Fresh water fish
 MOT: ingestion with PLEROCERCOID larva
 Pathology: Tapeworm anemia/ Vitamin B12 deficiency anemia

Egg
 Yellowish brown with

thick shell
 58 to 76µm by 40 to
51 µm
 Operculated with tiny

knob-like abopercular
thickening
Lab Dx
 DFS- eggs (no segment/ proglottid)
 Kato techniques
 Diphyllobothriasis VS PA (achlorhydria)
Treatment: Praziquantel
Taenia saginata Taenia solium
 CN Beef Tapeworm Pork Tapeworm
 IH Cattle Pig (“measly pork”)
 Scolex None, no rostellar hooks With rostellum armed

with 2 rows of large and
small hooklets
 Length 25 meters 7 meters
 # Proglottids 1000-2000 Less than 1000
 Gravid 15-20 lateral branhes 7-13 lateral branches

proglottid (Dichotomous/ Tree like) (Dendritic or fingerlike)
Taenia saginata Taenia solium
 Eggs Spherical, striated, inside is an embryo with 6 hooklets

(same)
 IS Cysticercus bovis Cysticercus cellulosae
 Mature Vaginal sphincter accessory ovarian lobe

segment
 Pathology Taeniasis saginata Taeniasis solium/

CYSTICERCOSIS
Taenia spp. Egg
 30 to 45 µm
 Thick brown striated

embryophore
 Hexacanth embryo
Taenia saginata
Taenia solium
Taenia solium
Scolex
Taenia solium
Cysticercus cellulosae
Lab Dx
 DFS – proglottids, eggs, or scolex
 Perianal swab
 ELISA
 Neurocysticercosis – CSF protein and glucose, CT SCAN, and MRI
 Opthalmic cysticercosis – ophthalmoscopy
Pathology
 Nonspecific abdominal complaints
 Cysticercosis – striated muscles, brain, and subcutaneous tissues
 Intraorbital pain and blurring of vision
Treatment: Praziquantel and Niclosamide

Taenia asiatica
 Often misidentified as Taenia saginata
 Present in the liver of IH : Cysticercus viscerotropica
 Scolex is devoid with hooklets
 11 to 32 lateral branches
Hymenolepis nana Hymenolepis diminuta
 CN Dwarf tapeworm Rat tapeworm
 Scolex With rostellum armed With an unarmed rostellum

with a ring of 20-30 spines
Y-shaped hooklets
 Eggs Eggs contain an oncosphere enclosed in an inner

membrane with two polar thickenings
**With 4-8 polar filaments **Without Filaments
 IS Direct: Egg Cysticercoid larva

Indirect: cysticercoid larva
 FH Man Rat
Egg

Egg

Scolex

Lab Dx
 DFS- eggs, scolex but not proglottids
Treatment
 Praziquantel
Dipylidium caninum
 Dog tapeworm / double-pored tapeworm / pumpkin seed tapeworm

 Proglottids have double set of reproductive organs and genital pore on
each side of the lateral margin
 Mature and gravid proglottid: Melon seeds/pumpkin seeds/ rice grains
 IH: Cat flea (Ctenocephalides canis)
Dog flea (Ctenocephalides felis)
Dog louse (Trichodectes canis)
Human flea (Pulex irritans)
 IS: Cysticercoid larva
Dipylidium caninum
Egg
 Egg in pockets
 8 to 15 eggs enclosed in
embryonic membrane
 Thin shelled with hexacanth

embryo
Dipylidium caninum
Scolex
 Pale reddish adult
 10 to 70 cm
 Thorn shaped hooklets ( 1 to 7

rows)
 Bilateral genital pores
 Pumpkin seeds gravid proglottid

Raillietina garrisoni
 60 cm with four acetabula
 90 to 140 Hammer-shaped hooks
 Spindle shaped eggs
 Grains of rice segements- motile
 IH: Flour beetle
 Lab Dx: DFS by identification of eggs and proglottid
 Treatment: Praziquantel
Flour Beetle (Tribolium spp.)
Raillietina garrisoni
Scolex
Echinococcus granulosus
 Hydatid worm producing hydatid disease
 Shortest tapeworm with only three

segments
 Eggs cannot be differentiated from eggs

of Taenia
 IS: Hydatid Cyst
 FH: Dog
Lab Dx
a. Exploratory cyst puncture
b. Roentgenogram (x-ray)
c. Immunologic test – Bentonite Flocculation test

Casoni: intradermal test
d. Serologic tests
Pathology: Extraintestinal Disease (Cystic Echinococcosis)
Treatment: Surgical resection, PAIR, Mebendazole or albendazole

Echinococcus granulosus:
Hydatid cyst
Echinococcus granulosus
Prominent scolex

CESTODES: Tapeworms and Their Characteristics

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CESTODES

Maricelle D. Manlutac, RMT, MPH, MLS(ASCPi)

 Adult: Flat and ribbon-like

Cestode body consist of:

 Species which require

 Species which may or may not

 Scolex Spoon-shaped with slit like Quadrate with four

 Ova Oval, operculated, immature Spherical, non-operculated,

 Larva Coracidium Cysticercoid

 Largest tapeworm of man

 Scolex: spatulate/ spoon-shaped/ almond shaped with sucking organ

 Uterus: Rosette formation

 1st IH: Crustaceaen/ Copepods

 2nd IH: Fresh water fish

 MOT: ingestion with PLEROCERCOID larva

 Pathology: Tapeworm anemia/ Vitamin B12 deficiency anemia

 Yellowish brown with

 Operculated with tiny

 CN Beef Tapeworm Pork Tapeworm

 IH Cattle Pig (“measly pork”)

 Scolex None, no rostellar hooks With rostellum armed

 Length 25 meters 7 meters

 # Proglottids 1000-2000 Less than 1000

 Gravid 15-20 lateral branhes 7-13 lateral branches

 Eggs Spherical, striated, inside is an embryo with 6 hooklets

 IS Cysticercus bovis Cysticercus cellulosae

 Mature Vaginal sphincter accessory ovarian lobe

 Pathology Taeniasis saginata Taeniasis solium/

 Thick brown striated

 Neurocysticercosis – CSF protein and glucose, CT SCAN, and MRI

 Opthalmic cysticercosis – ophthalmoscopy

 Nonspecific abdominal complaints

 Cysticercosis – striated muscles, brain, and subcutaneous tissues

 Intraorbital pain and blurring of vision

Treatment: Praziquantel and Niclosamide

 Often misidentified as Taenia saginata

 Present in the liver of IH : Cysticercus viscerotropica

 Scolex is devoid with hooklets

 CN Dwarf tapeworm Rat tapeworm

 Scolex With rostellum armed With an unarmed rostellum

 Eggs Eggs contain an oncosphere enclosed in an inner

**With 4-8 polar filaments **Without Filaments

 IS Direct: Egg Cysticercoid larva

Hymenolepis nana Hymenolepis diminuta

Hymenolepis nana Hymenolepis diminuta

Hymenolepis nana Hymenolepis diminuta

 Dog tapeworm / double-pored tapeworm / pumpkin seed tapeworm

 Thin shelled with hexacanth

 Thorn shaped hooklets ( 1 to 7

 Bilateral genital pores

 Pumpkin seeds gravid proglottid

 60 cm with four acetabula

 90 to 140 Hammer-shaped hooks

 Spindle shaped eggs

 Grains of rice segements- motile

 IH: Flour beetle

 Lab Dx: DFS by identification of eggs and proglottid

 Hydatid worm producing hydatid disease

 Shortest tapeworm with only three

 Eggs cannot be differentiated from eggs

 IS: Hydatid Cyst

c. Immunologic test – Bentonite Flocculation test

With 4-8 polar filaments Without Filaments