taeniasis MKT

7/24/2019 taeniasis MKT

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PendidikanPendidikan

MagisterMagister KedokteranKedokteran TropisTropis

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DepartemenDepartemen ParasitologiParasitologi


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Clinical caseClinical case

Anda adalah dokter yang bertugas di di

salah satu Puskesmas di KabupatenSamosir. Suatu kali seorang pasien lelaki

sepotong benda berukuran sekitar1x0.5cm bewarna putih susu, kenyal dan

bergerak aktif di dalam celana dalamnya.

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LearningLearning ObjectivesObjectives

1. Agent(s) of the disease

2. Nature of the disease

3. Risk factors

4. Complications5. Management: diagnosis, treatment,

prevention

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MorphologyMorphology

TapeTape--likelike

SegmentedSegmented Scolex (head)Scolex (head)11

Strobila, divided into proglottidsStrobila, divided into proglottids

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33

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Immature proglottidsImmature proglottids22

Mature proglottidsMature proglottids33

Gravid proglottidsGravid proglottids44

HermaphroditeHermaphrodite

Hooks and suckersHooks and suckers

GIT: nilGIT: nil

Body cavity absentBody cavity absent

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ClassificationClassification Intestinal cestodes:Intestinal cestodes:

Taenia saginataTaenia saginata

Taenia soliumTaenia solium

Hymenolepis nanaHymenolepis nana

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DiphyllobothriidaeDiphyllobothriidae

Zoonotic cestodes:Zoonotic cestodes: Echinococcus granulosusEchinococcus granulosus

Dypilidium caninumDypilidium caninum


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TaeniaTaenia sp.sp.

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TaeniaTaenia saginatasaginata

TaeniaTaenia soliumsolium


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Taenia saginataTaenia saginataBeef tapewormBeef tapeworm

Up to 1Up to 1--2k2kproglottidsproglottids

GravidGravid

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crawl out fromcrawl out fromanusanusvoluntarilyvoluntarily

Habitat: smallHabitat: smallintestineintestine


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Taenia saginataTaenia saginataLife cycleLife cycle

InfectiveInfectivestage:stage:

cysticercuscysticercusbovisbovis inincattle meatcattle meat

Route ofRoute of

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n ec on:n ec on:ingestioningestion

DxDx stage:stage:

eggs in feceseggs in fecesor anal swabor anal swab

gravidgravidsegmentssegments


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Taenia saginataTaenia saginataMorphologyMorphology

Scolex: 4 suckersScolex: 4 suckers

Gravid segment:Gravid segment: 1515--20 branches of20 branches of

uterusuterusAA

Genital ore: one ofGenital ore: one of

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each segment ineach segment inirregular siteirregular siteBB

EggEgg (viable up to 159 days)(viable up to 159 days)::

EllipticalElliptical

EmbryophoreEmbryophore (thick(thickshell with radial pattern)shell with radial pattern)

Content: hexacanthContent: hexacanthembryo (oncosphere)embryo (oncosphere)


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Taenia soliumTaenia soliumLife cycleLife cycle

InfectiveInfectivestage:stage:

cysticercuscysticercuscellulose incellulose inpork and orpork and oreggseggs

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ou e oou e oinfection:infection:ingestioningestion

DxDx stage:stage:

-- eggs in feces oreggs in feces or

swabswab-- cysticercuscysticercus

cellulose fromcellulose fromtissue biopsytissue biopsy


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Taenia saginataTaenia saginataLarvaLarva

CalledCalled cysticercuscysticercus

bovisbovis, no hooks, no hooks InvaginateInvaginate in cattlein cattle

muscles andmuscles and

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ssuesssues Ingested byIngested by

human,human, evaginateevaginatein small intestinein small intestineto become adultto become adultwormworm


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Taenia soliumTaenia soliumScolexScolex

Scolex: 4 suckers,Scolex: 4 suckers,

hooks, rostellumhooks, rostellum

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Taenia soliumTaenia soliumEggsEggs

Resembles theResembles the

eggs ofeggs of TaeniaTaeniasaginatasaginata

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Taenia soliumTaenia soliumStrobilaStrobila

Strobila:Strobila: 22--3 m long3 m long

less than 1k proglottidsless than 1k proglottids proglottid: less uterine branches (7proglottid: less uterine branches (7--1212

pairs)pairs)

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Taenia soliumTaenia soliumLarvaLarva

CalledCalled cysticercuscysticercus

cellulosecellulose, six hooked, six hooked Habitat:Habitat:

humans muscles andhumans muscles and

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Pigs muscles and tissuesPigs muscles and tissues


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Taenia soliumTaenia soliumLarvaLarva

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Clinical ManifestationsClinical Manifestations TaeniaTaenia soliumsoliummay cause cysticercosis. The

most severe cysticercosis is that which involveCNS (neurocysticercosis). Other sites arelungs, liver, and eyes.

Neurocysticercosis might cause meningitis,epilepsy, dementia, and can be fatal.

TaeniaTaenia saginatasaginatadoes not cause cysticercosis.

However, the voluntary excretion of thesegments might have the patients

uncomfortable and induce mental depression.

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ManagementManagement

Diagnosis is based on QDP

(questionnaire of demonstrationproglottids). Though possible, its hard to

.

Cysticercosis is found through radiologicexamination

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ManagementManagement The worms need to be expelled completely

from the intestine. We need to be sure that notonly have the proglottids, but also the scolexand neck been removed.

Laxatives to expel proglottids Niclosamide

Praziquantel 40mg/kgBW (single dose)

Surgery for the csticercosis.

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SoSo

1. Agent(s) of the disease?

2. Nature of the disease?

3. Risk factors?

4. Complications?5. Management: diagnosis, treatment,

prevention?

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taeniasis MKT