Cestodiasis

Cestodiasis (tapeworm infection) is caused by species of the phylum Platyhelminthes (flatworms), and include among others the pork tapeworm (Taenia solium) and the beef tapeworm (T. saginata).9,4 The tapeworm attaches itself to the mucosal wall of the upper jejunum by the scolex (mouth parts), and by two to four cup-shaped suckers and a structure called a rostellum, which may have hooks in some species. Since the parasite lacks a digestive system it obtains all nutrients directly from the host. The scolex, proglottids (segments), and eggs are specific for each species and used for identification of tapeworms. Tapeworm infections are caused by ingestion of poorly cooked meat which contains the larva or cysticerci. Cysticerci, when released from the contaminated meat by host digestive juices, mature in the host jejunum. Cystericer-cosis is a systemic disease caused by the larva of T. solium (oncosphere or hexacanth), and is usually acquired by ingestion of eggs in contaminated food or by autoinfec-tion.41-45 The larvae can penetrate the bowel and migrate through the bloodstream to infect different organs including the CNS (neurocysticercosis). Diagnosis of both T. saginata and T. solium is accomplished by recovery of the gravid proglottids and the scolex in the stool.

Treatment

Tapeworm infections (T. saginata and T. solium) are treated with praziquantel 5 to 10 mg/kg as a single dose (use the same dose for adults and pediatric patients).12 The treatment for cysticercosis and neurocysticercosis may include surgery, anticonvulsants (neurocysticercosis can cause seizures), and anthelmintic therapy. The anthelmintic therapy of choice is albendazole 400 mg twice daily for 8 to 30 days.45,46 The pediatric dose of albendazole is 15 mg/kg (maximum: 800 mg) in two divided doses for 8 to 30 days. The doses for both adults and pediatric subjects can be repeated if necessary. Praziquantel is an alternative therapy.1

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