Tapeworm Infection, Pork

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