Communicable Diseases



Taeniasis is an intestinal infection with the adult stage of large tapeworms; cysticercosis is a tissue infection with the larval stage of one species, Taenia solium. Clinical manifestations of infection with the adult worm, if present, are variable, and may include nervousness, insomnia, anorexia, weight loss, abdominal pain and digestive disturbances. Except for the annoyance of having segments of worms emerging from the anus, many infections are asymptomatic. Taeniasis is usually a nonfatal infection, but the larval stage of T. solium may cause fatal cysticercosis.

Cysticercosis is the larval infection of humans with the pork tapeworm. It may produce serious somatic disease, usually involving the CNS. When eggs or proglottids of the pork tapeworm are swallowed by humans, the eggs hatch in the small intestine and the larvae migrate to the subcutaneous tissues, striated muscles, and other tissues and vital organs of the body, where they form cysticerci. Consequences may be grave when larvae localize in the eye, CNS or heart. In the presence of somatic cysticercosis, epileptiform seizures, headache, signs of intracranial hypertension or psychiatric disturbances strongly suggest cerebral involvement. CNS cysticercosis, or neurocysticercosis, may cause serious disability, but with a relatively low case-fatality rate.

Infection with an adult tapeworm is diagnosed by identification of proglottids (segments), eggs or antigens of the worm in the feces or on anal swabs. Eggs of T. solium and T. saginata cannot be differentiated morphologically. Specific diagnosis is based on the morphology of the scolex (head) and/or gravid proglottids.

Specific serological tests should support the clinical diagnosis of cysticercosis. Subcutaneous cysticerci may be visible or palpable; microscopic examination of an excised cysticercus confirms the diagnosis. Cysticercosis in intracerebral and other tissues may be recognized by CAT scan or MRI, or by X-ray when the cysticerci are calcified.

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