General characteristics

• collectively called the FLATWORMS

• They are usually leaf shaped, oval, elongated
• dorsoventrally flattened, bilaterally symmetrical
• Size ranges from nearly microscopic to over 60 meters in
length.
• They are covered by a membrane called tegument (microvilli
that absorbs food from the host’s intestine)
• Body is covered by 3 layers of tissue with organs and
organelles
• Head is provided with sensory organs
• Body contains no internal cavity
• They do not have circulatory, respiratory, skeletal
system, digestive system is incomplete while absent
in others , lacks an anus. (flame cell- rotonephridium)
• They are hermaphrodite(sexes are combined in a
single organism), except for Schistosoma species
• Because of their elaborate nervous system, they are
found in a wide variety of habitat. (lakes, streams,
ponds, ocean sediments from pole to pole, moist
terrestrial environments.)
Cross sectional diagram of flatworms
Cross sectional diagram of flatworms
Class Cestoda
• Adult worm inhabit the small intestines of vertebrates
while the larvae parasitize different classes of vertebrates
and invertebrates
• Digestive system absent, food is acquired through
absorption from the host’s intestine.
• Ribbon like or tape like segmented parasites varying in size
from a few mm. to several meters
• Body consist of 3 distinct regions :
 HEAD or SCOLEX= organ of attachment provided with suckers
(bothrium or acetabulum), rostellum (armed w/ hooklets or
unarmed)
  NECK= which is the region of growth (immature
proglottids)
 STROBILA or BODY= which consists of series of segments
(PROGLOTTIDS) . These are complete reproductive unit.
Composed of 3 regions: Immature, Mature, Gravid.
• Most require Intermediate host to complete their life
cycle
• Life cycle includes: Egg stage- Hexacanth embryo (six
hooks, Oncosphere), The Larval stage (Coracidium, Procercoid,
Plerocercoid, Cysticercoid, Cysticercus larva) and the Adult stage
3 types of proglottid:

• Immature – undeveloped sexual organ,

nearest to the neck
• Mature – fully mature sexual organ
• Gravid – contains fertilized egg,
undergoes apolysis
• Apolysis- normal process of detachment of the
gravid proglottid from the adult worm
Adult worm Egg
General structure of Tapeworms
General anatomy of tapeworms
Order Pseudophyllidea-scolex patulate with
bothria

– Diphyllobothrium latum
• Scolex segments-
Genital pore + uterine pore
Order Cyclophyllidea-scolex globular with 4 cup like suckers

• Scolex segments- no
uterine pore undergo apolysis
 Ova (egg of parasite)
Pseudophyllidea Cyclophyllidea
EGGS EGGS
Operculated, Immature, requires aquatic Passed out readily with hexacanth embryo
vegetation to develop
 CLASS CESTODA
• Species which require vertebrate Intermediate Host
– Taenia solium
– Taenia saginata
• Species which require Invertebrate Intermediate HOST
– Hymenolepis diminuta
– Dipylidium caninum
• Species which may or may not require Intermediate Host
– Hymenolepis nana
• Species which infect man and their larval stage
– Echinococcus granulosus
– Taenia solium
– Diphyllobothrium latum
Diphyllobothrium latum
• “ Broad or Fish tapeworm”
• World wide in distribution, occurring in Northern
temperate areas of the world where pickled or
insufficiently cooked fresh-water fish are prominent in
the diet.
• High prevalence rate in humans is seen in Scandinavia,
Finland, Alaska, Canada, Japan
• Fish-eating mammals such as wild and domestic
members of the dog and cat families, bears, minks,
pigs, walruses and seals.
Life cycle
• Infective stage- Plerocercoid Larva
• Definitive host- Man, dog, cat and other fish
eating mammals
• 1st Intermediate host- copepod
• 2nd Intermediate host- Fresh-water fish
• Stage in man- Adult worm
• habitat in host- Small Intestine
 Morphology
Adult worm Ova

• Long, Tape-like, grayish yellow • 70 x 50um in diameter

• 3-10 m in length • has thin double contoured shell with a
SCOLEX- elongated, spoon shaped lid( operculum) at one end which may
(spatulate), with 2 longitudinal grooves or may not be open.
(bothria). With 2 suckers • yellowish brown in color
PROGLOTTIDS- 3000-4000. mature are • Ripe eggs escape through the uterine
broader than long. Uterus is centrally pore and are discharge into the
located and rosette shaped. Genital pore is intestine.
located in the middle.
D. latum
D. latum
 Pathology
Disease Clinical features- Signs & Diagnostic test T/P/C
Symptoms
Diphyllobothriasis • Majority • DFS – • Niclosamide
asymptomatic demonstration of • Praziquantel
• vague abdominal eggs + proglottids
• Ingestion of discomfort, diarrhea, • Serologic test- • cooked fish
larvae in nausea, weakness ELISA properly, brine
fresh-water • proximal portion of • CT/ MRI- cerebral cured or frozen
fish the jejunum- • Biopsy at neg.10° C for
tapeworm pernicious 24-48 hrs.
anemia due to Vit. • cooked animal
B12 deficiency meat properly
( absorbed by the • use of
worm) potentially
SPARGANOSIS- drinking infected
water containing animals for
copepods (procercoids). medicinal
Larva penetrates the purpose must
intestine and find its way be discourage
into the muscle or • avoid drinking
subcutaneous tissue to contaminated
grow into a water
SPARGANUM larva-
Pathology of sparganosis

• Sparganum larva- is a wrinkled, whitish, ribbon-shaped

organism, a few mm wide and up to several cm. long
• Early migratory stage are asymptomatic but when it
reached its final site and begins to grow, its presence
elicit a painful inflammatory reaction in the
surrounding tissue
• Eyes-ocular sparganosis; intense pain w/ periorbital
edema
• CNS-cerebral sparganosis; seizures, paresthesias,
hemiparesis
• Surgical removal of the larva- for Dx purposes
Dipylidium caninum
• “Dog and Cat flea tapeworm”
• Common parasite of domestic dogs and cats all
over the world
• Occasionally found in humans, particularly small
children
• Larva is known as cysticercoids
• The cysticercoid develops when the eggs/ova is
ingested by the cat/dog flea larva and retained
until it becomes an adult flea
D. caninum
• Infection takes place due to accidental ingestion
of fleas who kiss or are licked by their infected
pets.
• The gravid proglottid migrates to the anus and
remain on the exterior to contract and expand
releasing the packets of eggs in the anal area.
• larval fleas will then ingest the ova’s
• Definitive host= dogs, cats, man
• Intermediate host= Fleas
Life cycle
 Morphology
Adult worm Ova
• pale, reddish tape-like worm • spherical, thin hyaline shell
• 20-40 cm in length (ave. 15 cm) • 23-40 um in diameter
SCOLEX- small 250- 500 um in diameter, • hexacanth embryo
bears 4 suckers with retractile rostellum,
armed with 3-4 rows of hooks shaped like
a rose thorns. Neck is short and thin
• PROGLOTTIDS- mature are longer than
they are wide- vase-like or pumpkin
seed shaped containing 2 sets of
reproductive organs. Gravid are
shaped like the mature segment
(barrel like) and are filled with
polygonal uterine blocks- egg packets
containing 8-15 eggs enclosed in an
embryonic capsule/membrane.
Adult worm Ova
Adult worm I.H.
Pathology
Disease Clinical features (Signs & Diagnostic test T/P/C
Symptoms)
Dipylidium • Asymptomatic • DFS- • Niclosamide
infection • abdominal pain, demonstratio • Praziquantel
diarrhea n of egg
Zoonoses • Anal pruritus- packets or
Ingestion of proglottids are motile proglottids in • Periodic
infected Dog or when freshly pass and stool deworming of
Cat flea. might be mistaken for dogs and cats
maggots or fly larva.
Ctenocephalides • animals will scrape • maintenance of
canis / felis their anal region in dog and cat
grass or carpet to hygiene.
relieve itchiness.
Hymenolepis spp.
Hymenolepis nana Hymenolepis diminuta
• “dwarf tapeworm”- small • “Rat tapeworm”- Thread
thread like like flatworms
• Common parasites of house • Commonly parasites of rats
mouse
• World wide infection
• World wide infection
• Infection is seen most • Requires an arthropod I.H.
frequently in children but can to complete its life cycle
occur in adults as well
• May not require I.H. to
complete its life cycle.
 Morphology
Characteristics H.nana H. diminuta

Adult worm • 1-4 cm-L x 1mm in width • 10-60 cm-L X 4mm in width
 Morphology
Characteristics H. nana H. diminuta

Scolex • globular with 4 suckers-0.3 • globular with 4 suckers- 0.2-

mm in diameter 0.4mm in diameter
• provided with retractile • provide with unarmed
rostellum armed with single rostellum
row of 20-30 hooklets
 Morphology
Characteristics H. nana H. diminuta

Proglottids  up to 200 800-1000

• MATURE  Broader than long, 3 testes  Broader than long, 3 testes
• UTERUS  Irregular sac-like  Irregular sac-like
• GENITAL PORE  Lateral, on same side  Lateral, on same side
 Morphology
Characteristics H.nana H. diminuta

Ovum • broadly ovoid, covered with a • Has a thick yellow outer and
(Oncosphere) thin, hyaline smooth outer colorless (fine concentric
shell. straitions) inner membrane
with a granular intermediate
• Inner thick membrane with layer.
polar thickenings or knobs from
which project 4-8 long, thin • Has no polar filaments
polar filaments. (differential
features from H. diminuta) • Embryophore contain 6
hooklets arranged in fan
• The embryophores contain 6 shaped pattern (3 pairs)-
hooklets arranged in fan Hexacanth
shaped pattern (3 pairs)-
Hexacanth • Eggs are larger, which
measure 60-79 x 72-86 um in
• Eggs are release as the gravid diameter.
segments disintegrate, which
measure 30-45 um in diameter
Life cycle- H.nana
Life cycle – H. diminuta
Ova (Oncosphere)
• H. nana
Ova(Oncosphere)
• H. diminuta
Cysticercoid larva
H. nana H. diminuta
• Infective stage= • Infective stage=
Oncosphere/Cystecercoid Cystecercoid larva
larva • Definitive host= Rats, mice,
• Definitive host= Rats, mice, man , and dogs
and man • Intermediate host= Flea,
• Intermediate host= (can be grain or flour beetle,
optional)Flea , grain or flour cockroaches.
beetle, cockroaches. • Stage in man= Adult
• Stage in man= Adult or Larva
• Habitat= Small Intestine
• Habitat= Small Intestine
Pathology
Disease Clinical features Diagnostic test T/P/C
(Signs &
Symptoms)
Hymenolepiasis • Asymptomatic • DFS- • Praziquantel
• Enteritis demonstration of • Niclosamide
Ingestion of IH • abdominal pain, embryonated • Nitazoxanide
(diminuta) or headache,diarrh eggs in stool
oncosphere (nana) ea, anorexia (oncosphere) • maintenance of
personal hygiene
Oriental rat flea- • Environmental
Xenopsylla cheopis sanitation. (pest
Dog flea- and insect
Ctenocephalides control)
canis • Proper storage
Human flea- Pulex of grain and
irritans cereals,
Flour beetle- especially those
Tenebrio or consumed w/
Tribolium out cooking
Sawtoothed grain • proper disposal
beetle- Ahasverus of feces
advena
Intermediate host
• Rat flea/ Human • Flour beetle/ Grain
flea(2.5 mm) beetle(3-4mm)
Taenia spp.
Taenia solium Taenia saginata
• “Pork tapeworm” • “Beef tapeworm”
• Occurs when people eat cured or • Worldwide distribution
undercooked pork • Acquired through ingestion of raw
• Prevalent in Mexico, Latin America, or undercooked beef
Slavic countries, Africa, SE Asia, • Frequent infections occur in the US
China
• Life cycle similar to T. solium
• I.Host= Pig, Man, dogs, bears
• I. Host= Cow
• D. Host= Man
• D. Host= Man
• Stage in Man= Adult or larva
• Stage in Man= Adult
• Habitat= Small Intestine
• Habitat= Small Intestine
• Infective stage= Cysticercus
cellulosae • Infective stage= Cysticercus bovis
 Morphology
Characteristics T. solium T. saginata

Adult worm • whitish or creamy white, tape- • White and semi-transparent

like worm • 5-10 m but can reach up to 25 m
• 2-5 m but can reach up to 10 m
 Morphology
Characteristics T. solium T. saginata

Scolex • globular with 4 cup-like suckers • Quadrate with 4 cup-like suckers

• 1mm in diameter • 1-2 mm in diameter
• rostellum armed with 25-30 • no rostellum
hooklets
Cysticercoid
• Eggs ingested penetrate Intestinal wall and
enter blood stream (hooklets) lodge in any
tissue-voluntary muscles ( CNS-brain, eyes)
• Complete its development in about 2 months
• semitransparent, opalescent white, and
elongate in shape, measures 8-10mm x 5mm
in diameter
• Scolex bears suckers and hooklets
Cysticercus cellulosae-Bladder worm
C. cellulosae in different parts of the
body
Orbit(eyes)
Subarachnoid Brain
 Morphology
Characteristics T. solium T. saginata

Proglottid • 800-1000 • 1000-2000

• MATURE • Longer than broad, 12 mm x 6 • Longer than broad
• GRAVID mm • 15-30 lateral uterine branches
• GENITAL • 7-13 lateral uterine branches • Lateral alternate sides ,irregular
PORE • Lateral alternate sides ,irregular • Apolysis- singly ( 80K eggs )
• Apolysis- in chains (30-50 K eggs)
 Morphology
Characteristi T. solium T. saginata
cs
Ovum • spherical, yellow to brown in • resembles T. solium ova
color with a thick radially straited • Indistinguishable from each other
embryonic shell
• oncosphere with 3 pairs of
hooklets (Hexacanth)
• 31-43 um in diameter
Life cycle- Taenia spp.
Life cycle- Taenia spp.
Pathology
Disease Clinical features Diagnostic test T/P/C
(Signs & Symptoms)
Taeniasis • Asymptomatic • DFS- • Albendazole w/
• Vague abdominal demonstration of Dexamethasone
Ingestion encysted discomfort- embryonated eggs increase the
larva in muscle tissue abdominal pain, in stool effectivity in
of pork/beef hunger pangs, (oncosphere) or subarachnoid
chronic indigestion proglottids cysta(brain)
Criteria for successful • anorexia, nausea • Praziquantel-
TX= recovery of • Reverse peristalsis- parenchymal cyst
scolex+ negative stool carry egg in the • X-ray, CT scan, MRI • surgical removal
sample 3 months after upper portion of
Txreatment. duodenum • proper cooking of
meat
Cysticercosis • Bladder worm- • freezing -5°C for 4
Ingestion of eggs encystment of the days, -15°C for 3
larva in the days or -24°C for 1
only for T. solium muscles, CNS- day kills the larvae
brain, eyes, • proper disposal of
subcutaneous feces to prevent
tissue contamination of
• Siezures,Hydrocep food, water, soil
halus, visual
problems
Taeniasis
Taenia asiatica (Asian Taenia)
• First reported in Taiwan in 1980. Korea, China,
Philippines, Thailand , Malaysia, and Indonesia
• Raw or undercooked pork
• Does not produce cysticercosis in humans.
• Morphologically and genetically similar to T. saginata
• Cysticerci develop in the liver and other viscera of pigs
and not in the muscle
• Infects a range of I.H.= goats, monkey, wild boar, swine,
cattle
• D.H= Man
Scolex Proglottid
Echinococcus granulosus
• “Hydatid worm”
• Smallest tapeworm- scolex, a short neck and 3
proglottids
• causes Hydatid cyst that develops in the different
organs and tissues of the host
• 2 different life cycles- PASTORAL and SYLVATIC
• a serious infection in sheep-raising areas of
Australia, New Zealand, North and South
America, Europe, Asia, and Africa
• Goats, camels, reindeer, and pigs, together with
dogs maintain the cycle in various parts of the
world.
• Humans are infected when they accidentally ingest
the eggs, usually as a result of fondling dogs.
• D.Host= dogs, wolves or other carnivores
• I.Host= man, sheep, horses, goats, cattle, pigs
• Stage in man= Larva
• Location in man= Various organs
Morphology
Adult worm Hydatid cyst Ova
• small tapeworm measuring • INFECTIVE LARVA • similar to Taenia spp. ova
3-6 mm in length • embryo develops slowly
• It has 3 segments into a cyst reaching a
• SCOLEX- globular- 0.6 mm in diameter of 1cm in 5 mos.
width with 4 cup like suckers. Reach 20 cmin diameter
Rostellum bears a double • spherical in shape-
crown of 28-40 hooklets external laminated cuticle
• PROGLOTTID- (ectocyst). Inner germinal
• immature- longer than layer (endocyst) –masses
broad with immature of cells grow into the
reproductive organs cavity of the cyst. Become
• mature- longer than broad. vacoulated- Brood
Consist of 43-65 pyriform capsules containing
testes with irregular ovaries Protoscolices bud from the
at the posterior portion inner wall. Daughter cyst
• Gravid- 2-3 mm in L X appear w/in the hydatid.
0.6mm in width- biggest • HYDATID SAND- found in
segment. Median uterus w/ older cyst that contains
12-15 lateral pouches filled granular materials of free
w/ ova protoscolices, daughter
cyst
Adult worm
Scolex
Hydatid cyst
Ova Hydatid cyst
Life cycle
Pathology
Disease Clinical features Diagnostic Test T/P/C
(Signs & Symptoms)

Echinococcosis • Effects may not • X-ray, Ct scan, • Albendazole

(Hydatid disease) become apparent MRI • Praziquantel
for many years • Serologic test- • Ivermectin
Ingestion of Eggs after infection ELISA & IHA • surgical removal
bec. of its usual • aspiration of
slow growth. (20 hydatid fluid
yrs.)
• primarily affects • maintenance of
the liver, lungs, personal hygiene
brain, bones, and • avoid close
other organs contact with dogs
• proper disposal
of dog feces
E. granulosus
Radiographic slides
END of Cestodes
 THE END
Salamat po.