Dipylidiasis - Clinicals, Diagnosis, and Management

Infectious diseases

Clinicals - History

Fact Explanation
Abdominal pain Dipylidiasis is a common tapeworm (cestode) infection of dogs and cats caused by Dipylidium caninum. Dipylidiasis is a proved zoonosis. Humans are occasional hosts. The disease has a worldwide distribution and it is common among children who
plays with pet cats and dogs often. Human infection is usually accidentally occurs by swallowing adult fleas who are infested with Dipylidium caninum cysticercoids (larva).
Patients are usually asymptomatic. Symptoms of dipylidiasis are related to the worm burden. Abdominal pain may attributed to the trauma caused by adult worm to the intestinal wall. Rarely, patients may develop intestinal obstruction with severe mechanical occlusion of the lumen. In such cases severe abdominal pain in the periumbilical area.
Abdominal pain
Dipylidiasis is a common tapeworm (cestode) infection of dogs and cats caused by Dipylidium caninum. Dipylidiasis is a proved zoonosis. Humans are occasional hosts. The disease has a worldwide distribution and it is common among children who
plays with pet cats and dogs often. Human infection is usually accidentally occurs by swallowing adult fleas who are infested with Dipylidium caninum cysticercoids (larva).
Patients are usually asymptomatic. Symptoms of dipylidiasis are related to the worm burden. Abdominal pain may attributed to the trauma caused by adult worm to the intestinal wall. Rarely, patients may develop intestinal obstruction with severe mechanical occlusion of the lumen. In such cases severe abdominal pain in the periumbilical area.
Diarrhea Diarrhea is insidious and watery in type. This is not very common compared to abdominal pain. Diarrhea may be accompanied with nausea, vomiting and loss of appetite. Diarrhea
Diarrhea is insidious and watery in type. This is not very common compared to abdominal pain. Diarrhea may be accompanied with nausea, vomiting and loss of appetite.
Restlessness at night Migration of gravid segments to the perianal region causes restlessness and pruritus ani at night. Restlessness at night
Migration of gravid segments to the perianal region causes restlessness and pruritus ani at night.
Itchy rash Generalized toxic and allergic reactions causes red, itchy, raised areas of skin that appear in varying shapes and sizes. Itchy rash
Generalized toxic and allergic reactions causes red, itchy, raised areas of skin that appear in varying shapes and sizes.

Clinicals - Examination

Fact Explanation
Stool examination Direct examination of the stools may help to observe white motile segments of Proglottids of Dipylidium caninum. Examination of the peri anal area may also useful as segments can be found as they crawl out of the anus. These are important findings in terms of diagnosis. Stool examination
Direct examination of the stools may help to observe white motile segments of Proglottids of Dipylidium caninum. Examination of the peri anal area may also useful as segments can be found as they crawl out of the anus. These are important findings in terms of diagnosis.
Abdominal tenderness This may or may not be demonstrated in the epigastric region and is due to local allergic reaction of the intestine. Abdominal tenderness
This may or may not be demonstrated in the epigastric region and is due to local allergic reaction of the intestine.
Urticaria Red, itchy raised areas (hives) occur all over the body due to allergy. Urticaria
Red, itchy raised areas (hives) occur all over the body due to allergy.

Investigations - Diagnosis

Fact Explanation
Full blood count Parasitic infestation is characterized by high degree of eosinophilia in half of the cases. Full blood count
Parasitic infestation is characterized by high degree of eosinophilia in half of the cases.
Microscopic stool examination Stool specimen examination may show the characteristic egg packets and proglottids of Dipylidium caninum. Microscopic stool examination
Stool specimen examination may show the characteristic egg packets and proglottids of Dipylidium caninum.

Management - Supportive

Fact Explanation
Prevention Regular de-worming and insecticidal treatment of pets and restriction of fondling of pets by children are important preventive measures. Prevention
Regular de-worming and insecticidal treatment of pets and restriction of fondling of pets by children are important preventive measures.

Management - Specific

Fact Explanation
Praziquantel Single dose of 10-20 mg/kg after a light breakfast is recommended. Frequently occurring side effects are dizziness, headache, and malaise. Approximately 90% of all patients have abdominal pain or cramps with or without nausea and vomiting. Praziquantel
Single dose of 10-20 mg/kg after a light breakfast is recommended. Frequently occurring side effects are dizziness, headache, and malaise. Approximately 90% of all patients have abdominal pain or cramps with or without nausea and vomiting.
Niclosamide Niclosamide should be chewed thoroughly and be taken with water. 2g for adults as a single dose after a light breakfast is recommended. Dosage for children up to 2 years is 500mg and 1g for those between 3 to 6 years. Other drug are not effective. Niclosamide
Niclosamide should be chewed thoroughly and be taken with water. 2g for adults as a single dose after a light breakfast is recommended. Dosage for children up to 2 years is 500mg and 1g for those between 3 to 6 years. Other drug are not effective.

Concise, fact-based medical articles to refresh your knowledge

Access a wealth of content and skim through a smartly presented catalog of diseases and conditions.

  1. BUDKE CM, WHITE AC JR, GARCIA HH. Zoonotic larval cestode infections: neglected, neglected tropical diseases? PLoS Negl Trop Dis [online] 2009, 3(2):e319 [viewed 31 July 2014] Available from: doi:10.1371/journal.pntd.0000319
  2. CABELLO RR, RUIZ AC, FEREGRINO RR, ROMERO LC, FEREGRINO RR, ZAVALA JT. Dipylidium caninum infection. BMJ Case Rep [online] 2011 Nov 15 [viewed 31 July 2014] Available from: doi:10.1136/bcr.07.2011.4510
  3. ESLAMI A, RANJBAR-BAHADORI SH, MESHGI B, DEHGHAN M, BOKAIE S. Helminth infections of stray dogs from garmsar, semnan province, central iran. Iran J Parasitol [online] 2010 Dec, 5(4):37-41 [viewed 31 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/22347264
  4. MIN DY. Cestode infections in Korea. Kisaengchunghak Chapchi [online] 1990 Dec:123-44 [viewed 31 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/2133417
  5. NARASIMHAM MV, PANDA P, MOHANTY I, SAHU S, PADHI S, DASH M. Dipylidium caninum infection in a child: a rare case report. Indian J Med Microbiol [online] 2013 Jan-Mar, 31(1):82-4 [viewed 31 July 2014] Available from: doi:10.4103/0255-0857.108738
  6. WONG MH. Multiple infestation with Dipylidium caninum in an infant. Can Med Assoc J [online] 1955 Mar 15, 72(6):453-5 [viewed 31 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/14352116