Taenia saginata taeniasis / Beef tapeworm infection

Infectious diseases

Clinicals - History

Fact Explanation
Abdominal pain Taenia saginata taeniasis / Beef tapeworm infection is caused by a cestode called taenia saginata. It is found worldwide especially where beef is eaten raw or
undercooked. Cattle acquire infection via grass contaminated with human stools by direct contamination or when infected human stools are used as fertilization. Humans acquire infection from eating undercooked beef. Taenia saginata can remain in intestine without causing any harm for up to 25 years. Most are asymptomatic. And taenia saginata infection is usually mild disease as it does not cause Cysticercosis as Taenia solium does. The abdominal pain is colicky in nature more common during the morning and characteristically relieved by eating small amounts of food. The abdominal pain is localized to the epigastric /umbilical areas and are accompanied with nausea and epigastric distension. These symptoms are more pronounced in infants and children than in adults.
Abdominal pain
Taenia saginata taeniasis / Beef tapeworm infection is caused by a cestode called taenia saginata. It is found worldwide especially where beef is eaten raw or
undercooked. Cattle acquire infection via grass contaminated with human stools by direct contamination or when infected human stools are used as fertilization. Humans acquire infection from eating undercooked beef. Taenia saginata can remain in intestine without causing any harm for up to 25 years. Most are asymptomatic. And taenia saginata infection is usually mild disease as it does not cause Cysticercosis as Taenia solium does. The abdominal pain is colicky in nature more common during the morning and characteristically relieved by eating small amounts of food. The abdominal pain is localized to the epigastric /umbilical areas and are accompanied with nausea and epigastric distension. These symptoms are more pronounced in infants and children than in adults.
Diarrhea Diarrhea is accompanied by the abdominal pain. It is an insidiously onset, watery type of diarrhea. Diarrhea
Diarrhea is accompanied by the abdominal pain. It is an insidiously onset, watery type of diarrhea.
Passage of whitish segments with stools Most cases are asymptomatic, infection is noticed when white motile segments are seen in stools or when they crawl out of the anus. In fact, this is the most common and initial way of presentation. This may cause itching around the anus. Passage of whitish segments with stools
Most cases are asymptomatic, infection is noticed when white motile segments are seen in stools or when they crawl out of the anus. In fact, this is the most common and initial way of presentation. This may cause itching around the anus.
Nonspecific symptoms Weakness, loss of appetite, increased appetite, headache, constipation and dizziness are the other rare nonspecific symptoms. Nonspecific symptoms
Weakness, loss of appetite, increased appetite, headache, constipation and dizziness are the other rare nonspecific symptoms.
Complications In rare cases, tapeworm segments become lodged in the appendix and tend to mimic Appendicitis. Pain first, vomiting next and fever last has been described as the classic presentation of acute appendicitis. The abdominal pain first appears in the peri umbilical area and then migrates to the lower right part of the abdomen. Other complications reported; include obstruction of pancreatic duct, bile ducts, and
tapeworm growth in ectopic locations such as middle ear, adenoid tissue and uterine cavity. Taenia saginata does not cause Cysticercosis.
Complications
In rare cases, tapeworm segments become lodged in the appendix and tend to mimic Appendicitis. Pain first, vomiting next and fever last has been described as the classic presentation of acute appendicitis. The abdominal pain first appears in the peri umbilical area and then migrates to the lower right part of the abdomen. Other complications reported; include obstruction of pancreatic duct, bile ducts, and
tapeworm growth in ectopic locations such as middle ear, adenoid tissue and uterine cavity. Taenia saginata does not cause Cysticercosis.
Risk factors The tapeworms that cause taeniasis (Taenia saginata, T. solium, and T. asiatica) are found worldwide. Eating raw or undercooked beef or pork is the primary risk factor for acquiring taeniasis. The disease is relatively common in Africa, some parts of Eastern Europe, the Philippines, and Latin America. People who live in such countries and those who travel there are at higher risk. Risk factors
The tapeworms that cause taeniasis (Taenia saginata, T. solium, and T. asiatica) are found worldwide. Eating raw or undercooked beef or pork is the primary risk factor for acquiring taeniasis. The disease is relatively common in Africa, some parts of Eastern Europe, the Philippines, and Latin America. People who live in such countries and those who travel there are at higher risk.

Clinicals - Examination

Fact Explanation
Stool examination Direct examination of the stools may help to observe white motile segments of taenia on it. 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 taenia on it. 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. Sometime, when the taenia infestation gets complicated with acute appendicitis, rebound tenderness can be demonstrated in the right iliac fossa. Abdominal tenderness
This may or may not be demonstrated in the epigastric region. Sometime, when the taenia infestation gets complicated with acute appendicitis, rebound tenderness can be demonstrated in the right iliac fossa.

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 examination of stools Diagnosis is made by microscopic examination of eggs (rarely) or segments (commonly) in stools.
Segments are injected with Indian ink to highlight uterus and differentiation of T.saginata from T.solium can be done by the uterine pattern. There are 7-13 uterine branches for T solium whereas T. Saginata has 15-20 branches.
Examining the scolex also helps in differentiating the species as a T. solium scolex has 4 suckers with armed rostellum whereas T.saginata has got 4 suckers but no hooks. Still, this is examination scolex for the differentiation is less commonly used as the difficulty of locating the scolex is difficult and it can only be done following the treatment.
Determination of species on the basis of ova examination will be difficult because the eggs of the two (T. solium and T. saginata) are identical. An eggs composed of an outer shell with radial striations. The oncosphere in the inside cavity has got 3 pairs of hooklets.
Microscopic examination of stools
Diagnosis is made by microscopic examination of eggs (rarely) or segments (commonly) in stools.
Segments are injected with Indian ink to highlight uterus and differentiation of T.saginata from T.solium can be done by the uterine pattern. There are 7-13 uterine branches for T solium whereas T. Saginata has 15-20 branches.
Examining the scolex also helps in differentiating the species as a T. solium scolex has 4 suckers with armed rostellum whereas T.saginata has got 4 suckers but no hooks. Still, this is examination scolex for the differentiation is less commonly used as the difficulty of locating the scolex is difficult and it can only be done following the treatment.
Determination of species on the basis of ova examination will be difficult because the eggs of the two (T. solium and T. saginata) are identical. An eggs composed of an outer shell with radial striations. The oncosphere in the inside cavity has got 3 pairs of hooklets.
Enzyme-linked immunosorbent assay (ELISA) ELISA has a less importance in diagnosis and rarely performed. Enzyme-linked immunosorbent assay (ELISA)
ELISA has a less importance in diagnosis and rarely performed.

Management - Supportive

Fact Explanation
Prevention Beef should be well cooked before eating. (Critical temperature is 56 Celsius degrees). A food thermometer can be used to measure the internal temperature of cooked meat. Deep freezing below minus 10 Celsius degrees for 10 days will also kill cysticerci. All beef should be inspected for cysticerci or “measly beef”(white pin-head sized cysticerci) by public health officers. Prevention of unhygienic disposal of human stools is also important. Prevention
Beef should be well cooked before eating. (Critical temperature is 56 Celsius degrees). A food thermometer can be used to measure the internal temperature of cooked meat. Deep freezing below minus 10 Celsius degrees for 10 days will also kill cysticerci. All beef should be inspected for cysticerci or “measly beef”(white pin-head sized cysticerci) by public health officers. Prevention of unhygienic disposal of human stools is also important.

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. Albendazole is also very 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. Albendazole is also very 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. CHAI JY. Human taeniasis in the Republic of Korea: hidden or gone? Korean J Parasitol [online] 2013 Feb, 51(1):9-17 [viewed 29 July 2014] Available from: doi:10.3347/kjp.2013.51.1.9
  2. CHO J, JUNG BK, LIM H, KIM MJ, YOOYEN T, LEE D, EOM KS, SHIN EH, CHAI JY. Four cases of Taenia saginata infection with an analysis of COX1 gene. Korean J Parasitol [online] 2014 Feb, 52(1):79-83 [viewed 29 July 2014] Available from: doi:10.3347/kjp.2014.52.1.79
  3. GONZáLEZ LM, MONTERO E, HARRISON LJ, PARKHOUSE RM, GARATE T. Differential diagnosis of Taenia saginata and Taenia solium infection by PCR. J Clin Microbiol [online] 2000 Feb, 38(2):737-44 [viewed 29 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/10655377
  4. JEON HK, YONG TS, SOHN WM, CHAI JY, MIN DY, YUN CH, RIM HJ, PONGVONGSA T, BANOUVONG V, INSISIENGMAY B, PHOMMASACK B, EOM KS. Current status of human taeniasis in Lao People's Democratic Republic. Korean J Parasitol [online] 2013 Apr, 51(2):259-63 [viewed 29 July 2014] Available from: doi:10.3347/kjp.2013.51.2.259
  5. JESUDOSS AV, KAYA M, LISA S, ROHATGI A. Wormy surprise! BMJ Case Rep [online] 2012 Jun 21 [viewed 29 July 2014] Available from: doi:10.1136/bcr.12.2011.5416
  6. LATEEF M, ZARGAR SA, KHAN AR, NAZIR M, SHOUKAT A. Successful treatment of niclosamide- and praziquantel-resistant beef tapeworm infection with nitazoxanide. Int J Infect Dis [online] 2008 Jan, 12(1):80-2 [viewed 29 July 2014] Available from: doi:10.1016/j.ijid.2007.04.017
  7. WRIGHT EP, JAIN S. Human infestation by Taenia saginata lasting over 20 years. Postgrad Med J [online] 1984 Jul, 60(705):495-6 [viewed 29 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pubmed/6463005