Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 35-18: Noninvasive Cestode Infections + Key Features Download Section PDF Listen +++ +++ Essentials of Diagnosis ++ Generally asymptomatic Abdominal pain and other gastrointestinal symptoms may be present Eosinophilia common +++ General Considerations ++ Six tapeworms infect humans frequently The large tapeworms are Taenia saginata (the beef tapeworm, up to 25 m in length) Taenia solium (the pork tapeworm, 7 m) Diphyllobothrium latum (the fish tapeworm, 10 m) The small tapeworms are Hymenolepis nana (the dwarf tapeworm, 25–40 mm) Hymenolepis diminuta (the rodent tapeworm, 20–60 cm) Dipylidium caninum (the dog tapeworm, 10–70 cm) Humans are the only definitive host of T saginata and T solium Humans are infected by eating raw or undercooked infected beef An adult tapeworm consists of a head (scolex), a neck, and a chain of individual segments (proglottids) in which eggs form in mature segments +++ Demographics ++ Infection most common in cattle breeding area Gravid segments of T saginata are passed in human feces to soil, where they are ingested by grazing animals, especially cattle The eggs then hatch to release embryos that encyst in muscle as cysticerci + Clinical Findings Download Section PDF Listen +++ +++ Symptoms and Signs ++ Most infected persons are asymptomatic Abdominal pain and other gastrointestinal symptoms may be present +++ Differential Diagnosis ++ Pork, fish, dwarf, rodent, or dog tapeworms Chronic fatigue syndrome Chronic hepatitis Irritable bowel syndrome Amebiasis Ascariasis Enterobiasis (pinworm, mostly children) Hookworm disease Strongyloidiasis Celiac disease or tropical sprue Pernicious anemia (D latum) + Diagnosis Download Section PDF Listen +++ +++ Laboratory Tests ++ Complete blood count; eosinophilia is common +++ Diagnostic Procedures ++ Infection is often discovered by finding passage of proglottids in stool + Treatment Download Section PDF Listen +++ +++ Medications ++ Praziquantel Treatment of choice Single dose of 5–10 mg/kg orally is highly effective Side effects include headache, malaise, dizziness, abdominal pain, nausea Niclosamide Alternative therapy Single dose (2 g for adults, chewed) is effective Side effects include nausea, malaise, abdominal pain + Outcome Download Section PDF Listen +++ +++ Prognosis ++ Excellent with therapy +++ When to Refer ++ For assistance in making the diagnosis Inability to clear the infection +++ Prevention ++ Cysticercus bovis is killed by cooking at 56°C or freezing at –10°C for 5 days Pickling is not adequate + Reference Download Section PDF Listen +++ + +Craig P et al. Intestinal cestodes. Curr Opin Infect Dis. 2007 Oct;20(5):524–32. [PubMed: 17762788]