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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Cyclophyllidian gut tapeworms

Chapter:
Cyclophyllidian gut tapeworms
Author(s):

Richard Knight

DOI:
10.1093/med/9780199204854.003.071002_update_001

Update:

Epidemiology—Geographic distribution updated; Taenia asiatica now known to be quite widespread in east Asia and South-East Asia.

Phylogeny—human taeniasis predates domestication of cattle and pigs.

Updated on 31 May 2012. The previous version of this content can be found here.

The cyclophyllidean tapeworms are cestodes that maintain anchorage to the host small-gut mucosa by means of a scolex bearing four suckers; mature reproductive proglottids develop at the end of the worm. The life cycle involves a cystic larval stage, usually in a nonhuman host species. Humans are an obligatory part of the life cycle in four gut species; in the rest they are an accidental host.

Taenia saginata

The beef tapeworm is common in Africa, the Middle East, Asia and South America. It remains endemic, although now rare, in the United States of America and western Europe. Transmission occurs where cattle have access to human faeces and where humans eat undercooked beef containing cysts. Many people who are infected have no symptoms, except that they experience active exit of single proglottids through the anus. Diagnosis is by finding typical eggs in perianal swabs. Treatment is with niclosamide or praziquantel. Prevention is by health education concerning production and cooking of meat, also by proper sewage treatment and disposal. Mass treatment of selected or whole adult populations is the most effective short-term measure when endemicity is high.

Taenia asiatica

Adult worms resemble T. saginata but the cysts are much smaller and occur in the liver of pigs and wild boar. First recognized in 1973 and now known to be quite widespread in east Asia and South-East Asia. Cattle are not involved in the life cycle.

Taenia solium

Adult pork tapeworm infections occur when cysts in undercooked pig meat are eaten. High prevalences occur in Africa, parts of Asia, and Central and South America. Symptoms, diagnosis and treatment are similar to those of T.saginata. The potentially dangerous condition of cysticercosis occurs when eggs from the faeces of persons harbouring adult worms are ingested; this produces cysts in striated muscle, subcutaneous tissue, nervous system and the eye. See Chapter 7.10.3 for further discussion.

Other tapeworms

Several species are recognized as accidental human parasites, but Hymenolepis nana, the dwarf tapeworm, is common; the life cycle involves only humans. Heavy infection can lead to anorexia, abdominal pain, and malabsorption. Diagnosis is by finding eggs in the faeces. Treatment is with praziquantel or niclosamide.

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