Hymenolepiasis B71.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Rodentolepiasis

Definition
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Zestoden infection with the dwarf tapeworm Hymenolepis nana.

Pathogen
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  • Zestode, adults: 2-6 cm long and up to 1 mm wide. Hooks on the head for adhesion to the intestinal mucosa are present. The adults contain up to 200 proglottides.
  • With the hooks the parasites attach themselves to the intestinal mucosa. The females release approx. 100-200 eggs/segment; the eggs are excreted with the stool and taken up by fleas or grain beetles. The cysticercoid develops in these.
  • The beetles are ingested together with cereal meal by humans. In humans, the larvae are released; the scolex settles in the duodenum of the final host and begins to form proglottide chains (strobila). The preparation time (time until egg excretion) is about 7 days.
  • In case of autoinfection by faecal-oral uptake of eggs, the preparation time is about 2-3 weeks. Endogenous autoinfection and infection from person to person are possible.

Occurrence/Epidemiology
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Occurs in warm climates around the world, especially in developing countries. The number of infected people worldwide is about 75 million. Prevalence: up to 20% of the population in endemic areas (e.g. Iran).

Manifestation
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Mainly occurring in children.

Clinical features
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  • Symptoms depend on the number of adult worms (up to several hundred are possible), milder infections are asymptomatic. Not infrequently, the disease triggers acute urticaria, which can become chronic if the disease is not recognised or treated.
  • Typical symptoms: perianal and nasal itching, diarrhoea, abdominal pain (sometimes cramping), restlessness, sleep disorders.
  • Less frequently: anorexia, vomiting, bloody diarrhoea, myalgia, headache, seizures.

Laboratory
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Bluteosinophilia.

Diagnosis
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Microscopy of the stool: Adults: length of 1-4 cm, in rare cases up to 6 cn, width of max. 1 mm. Hooked ring and four suction cups on the head (scolex) and non-pronounced proglottids.

Notice!

The hooked wreath is the distinguishing feature to the rat tapeworm Hymenolepis diminuta.

Therapy
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  • Praziquantel (Biltricide; Cesol): Single dose 25 mg/kg bw p.o. (effective against adults and cysticercides).
  • Alternatively: Niclosamide (Yomesan): 2 g/day p.o. for 7 days, if necessary repeat after 3 weeks (effective only against adults).

Progression/forecast
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With good immunity and nutritional condition, spontaneous healing is possible.

Literature
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  1. Dönges J (1988) Parasitology. With special consideration of human pathogenic forms". Thieme, Stuttgart
  2. Mehlhorn H, Piekarski (2002) Ground plan of the parasitology, 6th edition. Spektrum Akademischer Verlag, Heidelberg

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020