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Essentials of Diagnosis
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Light infection generally asymptomatic
Abdominal discomfort, anorexia, diarrhea seen in heavy infection, which is common, especially in children
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General Considerations
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Six tapeworms infect humans frequently
The small tapeworms are
Hymenolepis nana (dwarf tapeworm, 25–40 mm; can reach 5 cm)
Hymenolepis diminuta (rodent tapeworm, 20–60 cm)
Dipylidium caninum (dog tapeworm, 10–70 cm)
The large tapeworms are
Taenia saginata (beef tapeworm, up to 25 m)
Taenia solium (pork tapeworm, 7 m)
Diphyllobothrium latum (fish tapeworm, 10 m)
H nana is the only tapeworm that can be transmitted between humans
Infection follows ingestion of food contaminated with human feces
Eggs hatch in the intestines, where oncospheres
Autoinfection can lead to amplification of infection
Infection with H nana, the related rodent tapeworm H diminuta, or the dog tapeworm D caninum can also follow accidental ingestion of infected insects
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Differential Diagnosis
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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)
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Diagnosis is 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
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Praziquantel
Treatment of choice
Dosage: 25 mg/kg orally
Not effective against maturing cysts
For heavy infections, repeat treatment after 1 week and screen after therapy to document cure
Side effects include headache, malaise, dizziness, abdominal pain, nausea
Niclosamide
Alternative therapy
For adults, 2 g chewed is effective
Continue therapy daily for 1 week
Side effects include nausea, malaise, abdominal pain
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Panti-May
JA
et al. Worldwide overview of human infections with
Hymenolepis diminuta. Parasitol Res. 2020;119:1997.
[PubMed: 32211990]