Intestinal cestodes tissue cestodes.pdf

Common Small Intestinal Cestodes ILOs At the end of this session, the student will be able to: ▪ Understand epidemiological disease distribution both worldwide as well as in areas of high endemicity in Egypt. ▪ Recognize hydatid, cysticercosis,sparganosis and coenuriosos inf...

Common Small Intestinal Cestodes ILOs At the end of this session, the student will be able to: ▪ Understand epidemiological disease distribution both worldwide as well as in areas of high endemicity in Egypt. ▪ Recognize hydatid, cysticercosis,sparganosis and coenuriosos infections as zoonotic disease where man is an accidental intermediate host. ▪ Understand pathophysiological mechanisms of cyst development in the human body. ▪ Recognize hydatid disease as a cause of single or multiple cysts of the liver, spleen, and lungs. ▪ Differentiate hydatid disease from other causes of cystic diseases of the liver, spleen, or lungs. ▪ Utilize laboratory and radiological investigations to reach a final diagnosis. ▪ Design an appropriate management strategy according to the site and stage of disease. ▪ Understand the role of medical treatment in managing hydatid and other tissue cystodes disease. ▪ Understand appropriate preventive measures for tissue cystodes based on an understanding of their life cycle. A) Taenia Saginata: ◼ G.D: W.W, common in Africa where beef is eaten raw and undercooked. ◼ Etiology and life-cycle: Scolex Mature segment [proglottids] Eggs with oncospheres Cysticercus never described in a human.  ◼ Transmission: Human infection acquired by eating undercooked beef containing the cysticerci. Cattle infection by eating grass contaminated by infected human faeces. ◼ Pathology: slight erosion of the m.m at the site of attachment. ◼ Immunity: reinfection is common i.e no protective immunity. ◼ CP: Largely asymptomatic, Motile proglottids,segments in faeces. Irritable bowel-type symptoms may occur. Segments or worms may be vomited. Eosinophilia is not a feature of established infection. Complications The worm may produce intestinal obstruction. Sporadically straying T. saginata proglottids become lodged in the appendix, or the bile and pancreatic ducts and can cause acute or subacute appendicitis or cholangitis and pancreatitis.  ◼ Diagnosis: characteristic acid-fast eggs in stools or intact proglottids. ◼ Treatment: a single oral dose of praziquantel at10mg/kg is effective. Niclosamide[yomesan] ◼ N.B: T.solium is a pork tapeworm, adult is smaller, scolex with 2 rows of hooks, proglottids less motile. Chief importance: human readily infected by larval cysticerci and adult worms, human cysticercosis, may also be acquired by faeco-oral auto- infection Hymenolepis nana (Dwarf tapeworm) G.D: warm countries; Egypt, Sudan, India, Japan, South America. Etiology & life-cycle: Adult worm 3-4cm long Scolex with 4 suckers A rostellum with a crown with hooks. Transmission: faeco-oral transmission (direct man to man) autoinfection Pathology: heavy infection 1000w → lesions Clinical picture: Abdominal pain and anorexia Allergy Eosinophilia is common Growth retardation has been reported Diagnosis: characteristic ova can be detected in stools. Treatment: -Praziquantel in a single oral dose at 20-40 mg/kg ± repeated weekly for 2 to 3 courses -Niclosamide[yomesan] 2g/dayx7days {±repeated after 10 days} Or 2g on first day →1g/day for 5 days