A co-infection case report of Taenia saginata in a patient with subclinical clonorchiasis confirmed by the combination of diagnostic tools.

BACKGROUND: Clonorchiasis is the common parasitic infection in the general population of the Republic of Korea, however, taeniasis is scarcely reported recently. Here, we describe a case of co-infection with the cestode T. saginata in a patient with subclinical clonorchiasis diagnosed by a combination of diagnostic tools in Korea. CASE PRESENTATION: A 56-year-old man visited the hospital having passed proglottids in his stool for the past two months and brought a stool sample with segments to our hospital. He had no abdominal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, or constipation. He used to consume raw beef and fish frequently. We could not find evidence of gravid proglottids which contain fully developed uteri filled with ova or branched uterine structures, within the submitted sample. To identify the tapeworm species, we carried out molecular analyses on the proglottids. The cox1 and ef1a sequences had a 100% match with those of T. saginata and differed from the sequences of the other Taenia species. Upon examination of stool samples fixed by formalin-ether concentration method, no Taenia species ova were observed in 10 slides. Instead, C. sinensis ova were observed, despite the level of IgG specific to C. sinensis being within the normal range. The patient was treated with praziquantel (25 mg/kg, three times a day) for 3 days, and subsequently C. sinensis ova were not found in his stool. CONCLUSION: Our case indicates that a combination of morphological, serological, and molecular diagnostic tools should be used for the accurate diagnosis of subclinical parasitic infections.

TAENIA SAGINATA INFECTION IN A 14-MONTH-OLD TODDLER.

A 14-month-old female toddler presented with a 3-day history of pass- ing gravid proglottids of Taenia saginata. Neither she nor her family members had a history of eating raw beef or other raw meat. Single doses of praziquantel and niclosamide were administered. To the best of our knowledge, this is the youngest described patient with T. saginata infection to date.

Taenia: An Uninvited Guest.

BACKGROUND: Taenia saginata and Taenia solium species are worldwide in distribution, causing bovine and porcine cysticercosis, and taeniasis in humans having the greatest economic and medical importance. CASE REPORT: A 55-year-old woman living in a village around Rasht (northern Iran) was referred to our hospital with a history of chronic abdominal pain and recent dyspepsia and epigastric fullness. According to her clinical history, she was a candidate for an upper gastrointestinal endoscopy. A large tape worm was seen in the stomach. Our efforts at extracting it from the stomach were unsuccessful. The endoscope was withdrawn and therapy with niclosamide was initiated. At the next visit, her symptoms were alleviated and she was relieved from the chronic pain. CONCLUSIONS: We believe that the retrograde migration of the tapeworm into the stomach may be due to low gastric acidity as a result of atrophic gastritis and chronic proton pump inhibitor use.

Rare case of disseminated cysticercosis and taeniasis in a Japanese traveler after returning from India.

We report disseminated cysticercosis concurrent with taeniasis in a 31-year-old male Japanese, who had visited India three times and stayed for 1 month each time during the previous 1 year. The patient presented increasing numbers of subcutaneous nodules and expelled proglottids, although numerous cysts were also found in the brain in imaging findings, though no neurological symptoms were observed. Histopathological and serological findings strongly indicated cysticercosis. We found taeniid eggs in his stool by microscopic examination and revealed them as the Indian haplotype of Taenia solium by mitochondrial DNA analysis. We concluded that disseminated cysticercosis was caused by the secondary autoinfection with eggs released from the tapeworm carrier himself. After confirming the absence of adult worms in the intestine by copro-polymerase chain reaction, the patient was successfully treated with albendazole at a dose of 15 mg/kg/day for 28 days. Subcutaneous and intracranial lesions had completely disappeared by the end of the treatment period.

Taeniasis-cysticercosis in Southern Ecuador: assessment of infection status using multiple laboratory diagnostic tools

Taenia solium-taeniasis and cysticercosis were studied in the human and porcine populations of a rural community in the Southern Ecuadorian Andes. From the 1059 inhabitants, 800 serum samples and 958 stool samples could be collected. In addition, 646 from the estimated 1148 pigs were tongue inspected. Circulating antigen was detected by enzyme linked immunosorbent assay (Ag-ELISA) in 2.25 percent of the human population, whereas intestinal taeniasis was detected in 1.46 percent by the formalin-ether technique. Following treatment and recovery of tapeworm fragments these were all identified as T. solium. Porcine cysticercosis was diagnosed in 3.56 percent of the pigs by tongue inspection. In addition, enzyme linked immunoelectrotransfer blot (EITB) was performed on a subset group of 100 humans to confirm the results of the Ag-ELISA. One hundred serum samples from pigs were also analysed by EITB. It appeared that 43 and 74 percent of humans and pigs had antibodies against T. solium cysticerci, respectively. It is concluded that contrary to the high exposure of the human population to T. solium that is suggested by EITB, the number of active cysticercosis cases, diagnosed by Ag-ELISA, was low, which may indicate endemic stability. The further use of complementary diagnostic methods for a better understanding of the epidemiology of T. solium is suggested.

The use of urban sewage sludge on pastures: the cysticercosis threat.

Urban sewage production is increasing and its agronomical use as a fertiliser has been advocated. Considerable defiance is prevalent in consumers and among farmers on the use of such fertilisers due to unknown pathological or environmental risks. The aim of the present review was to consider which pathological risk is major. Cysticercosis due to Taenia saginata appears to be one of the major pathological threats when sewage sludge is used to fertilise cattle pastures in temperate areas. The situation is different in Africa (Taenia solium and T. saginata are both highly prevalent) and Asia (Taeniasaginata-like are prevalent). The processing of sludge and the delay between its application onto a pasture and grazing are probably major risk factors. Little data are available on the influence of processing, delay between processing and the use of sludge on the pathogenic risk. Producers and consumers will be more confident on the use of sludge if objective data are gained on risk. Most of the cases of cysticercosis (North America, United-Kingdom, Germany or Denmark) are related to poor human hygiene or accidental overflooding of sewage plants onto pastures. The standard application of sludge on pastures is apparently at low risk. This low risk does not mean that surveillance should cease since outbreaks of cysticercosis have been reported. Future investigations should concentrate on the most sustainable means of reducing risk (length of storage before use, composting, other treatments).

Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil.

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Foi realizado inquérito epidemiológico em 3344 indivíduos da área urbana de Lagamar, Minas Gerais, Brasil, durante 1992-1993 para avaliar os principais fatores de risco relacionados com teníase e cisticercose. Foram visitadas 875 (78,9%) casas e examinados clinicamente 1080 (32,3%) indivíduos. As condições sanitárias deficientes estiveram associadas estatisticamente com história anterior ou atual de teníase ou de convulsões entre os membros de cada família (p < 0,05). A correlação entre teniase e convulsões foi evidenciada tanto no inquérito domiciliar como durante a avaliação clínica dos indivíduos (p < 0,0001). O risco relativo de convulsões foi de 2,3 entre os moradores entrevistados no domicílio e 1,7 entre os indivíduos que compareceram para exame clínico, respectivamente. A criação de suínos no peridomicílio e os portadores crônicos de teníase são fatores determinantes na perpetuação do elo epidemiológico teníase-cisticercose nas áreas endêmicas.

Sociocultural factors and local customs related to taeniasis in east Asia.

Taeniasis is an important medical and economic problem in many countries in East Asia. According to our estimation, there is an annual loss of US$18,673,495, US$13,641,021, and US$2,425,500 due to taeniasis in the mountainous areas of Taiwan, Cheju Island of Korea, and Samosir Island of Indonesia, respectively. Although taeniasis and cysticercosis due to Taenia solium have been reported, T. saginata asiatica is the dominate species in part of the world, especially in the mountainous and remote areas where the inhabitants are fond of eating raw or undercooked meat and/or viscera of domestic or wild animals. Therefore, sociocultural factors and local customs are the determinants in the transmission of taeniasis. In this paper, local customs and sociocultural factors including local dishes, accidental infection during dish preparation, and treatment for anaemia of children in the countries of East Asia were reviewed.

Studies on helminthosis at the Centre for Tropical Veterinary Medicine (CTVM).

The research work relating to helminths, which has been conducted within the Helminthology Section of the CTVM, often in collaboration with colleagues from the tropics is reviewed and placed into a historical perspective. The research has, in the main, concentrated on the trematodes Fasciola hepatica and Fasciola gigantica and the cestodes Taenia saginata and Taenia solium, but work on other parasites including gastro-intestinal nematodes is also considered. All of these parasites are of obvious veterinary/economic importance particularly in the tropics and subtropics. While the zoonotic importance of T. saginata and T. solium has been recognised for many years, it is only more recently that the zoonotic impact of Fasciola spp. has been generally acknowledged.

Review of taeniasis in Asia.

Although Asian Taenia is closely related to T. saginata, it is a genetically distinct entity and can be distinguished from the classical T. saginata. Man is the only definite host of this parasite. The domestic pig and wild boar in Taiwan as well as domestic pig in Korea have been determined to be the natural intermediate hosts. Moreover, the pig has been demonstrated to be the most favorable experimental intermediate host. The cysticerci are situated mainly in the liver. They are smaller than T. saginata cysticerci and have a shorter developmental period of four weeks. The scolex of Asian Taenia cysticercus is often armed with two rows of hooklets. The adult worm of Asian Taenia is shorter and has less number of segments than the classical T. saginata. Recently, results of polymerase chain reaction studies indicate that the Asian Taenia is much more closely related to T. saginata than other taeniid species. Therefore, it is appropriate to designate Asian Taenia as a new subspecies of Taenia saginata asiatica. People in the Asian-Pacific region acquired the infection by eating raw or undercooked meat and/or viscera of pigs. Human experimental infections have succeeded in confirming the life cycle of Asian Taenia and the transmission pathway of the infection. In addition, multiple infection occurs very often and the infection has a family pattern. "Discharge of proglottids" is the most important clinical manifestation which is also useful in the diagnosis. Praziquantel is the drug of choice. The infection of Asian Taenia can be prevented by avoiding to eat raw or undercooked meat and viscera of pigs in the endemic regions.