Page 133 - Medical Parasitology_ A Textbook ( PDFDrive )

126 11 Cestodes: Tapeworms

Diagnosis of Taeniasis
1. Microscopic examination
Detection of characteristic eggs, scolex or gravid proglottids of Taenia in fae-
ces. Species identification cannot be made from the eggs since the eggs of T.
saginata and T. solium look alike. Eggs can also be detected around the perianal
region by cellophane swab technique.
2. Molecular diagnosis
PCR on faecal sample.

Diagnosis of Cysticercosis
1. Serodiagnosis
2. Biopsy
HPE examination of biopsied lesion to show the invaginated scolex with
suckers and hooks.
3. Imaging
Calcified cysticerci can be detected by radiography of subcutaneous tissue
and muscles. X-ray of the skull may demonstrate calcified cyst in the brain.
CT scan of brain is the best method for detecting dead calcified cysts. MRI
scan of the brain is more helpful in detection of non-calcified cysts and ven-
tricular cysts.

Treatment
1. Intestinal taeniasis
Praziquantel (5–10 mg/kg orally in a single-dose therapy) is the drug of
choice. Niclosamide (2 g orally in a single-dose therapy) is an alternative drug.
2. Cysticercosis
Excision is the best method, where the cysts are accessible. For cerebral
cysticercosis, praziquantel (50 mg/kg in 3 divided doses daily for 15 days)
and albendazole (15 mg/kg daily (maximum 800 mg/day) for 8 days) may be
administered. Corticosteroids may be given along with praziquantel or alben-
dazole to reduce the inflammatory reactions caused by the dead cysticerci.
Antiepileptic drugs should be given. Surgical intervention is indicated for
hydrocephalus.

Prevention and control
1. Proper cooking of beef and pork
2. Proper sanitation
3. Personal hygiene
4. Avoid eating raw vegetables grown in polluted soil to prevent from acquiring
cysticercosis
5. Treatment of cases with taeniasis solium as they can develop cysticercosis due to
autoinfection