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Key Features

  • Generally asymptomatic

  • Can cause nonspecific gastrointestinal symptoms (eg, nausea and diarrhea)

  • Humans can be either the definitive or intermediate host of Taenia solium

    • Become definitive host after consuming undercooked pork, leading to tapeworm infection

    • Become intermediate host after consuming food contaminated with human feces containing T solium eggs, leading to cysticercosis

  • Transmission of eggs may occur as a result of

    • Autoinfection (hand to mouth)

    • Direct person-to-person transfer

    • Ingestion of food or drink contaminated by eggs

    • Rarely, regurgitation of proglottids into the stomach

Clinical Findings

  • Large tapeworms are generally asymptomatic

  • Occasionally, patients may have vague gastrointestinal symptoms

    • Nausea

    • Diarrhea

    • Abdominal pain

  • Systemic symptoms may be present

    • Fatigue

    • Hunger

    • Dizziness

  • Vomiting of proglottid segments or obstruction of the bile duct, pancreatic duct, or appendix is rare

Diagnosis

  • Diagnosis usually made based on the identification of characteristic eggs or proglottids in stool

  • Egg release may be irregular, so examination of multiple specimens or concentration techniques may be needed

Treatment

  • Praziquantel

    • Treatment of choice

    • Single oral dose of 5–10 mg/kg is highly effective

    • Side effects may include headache, malaise, dizziness, abdominal pain, nausea

  • Niclosamide

    • Alternative therapy

    • Single dose of 2 g for adults, chewed, is effective

    • Side effects may include nausea, malaise, abdominal pain

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