المحاضرة 5 مادة الطفيليات

Hymenolepis nana & Hymenolepis diminuta
Dr. Talal Saeed Alwajeeh
‫المحاضرة الخامسة‬
Hymenolepis nana
It is the smallest cestode infecting man, hence called as dwarf tapeworm.
Distribution
It is cosmopolitan in distribution but is more common in tropical countries.
Infection is most common in children.
Habitat
The adult worm lives in the ileum of human.
Morphology
Adult worm:
The adult form is small, 1–4 cm in length and consists of head, neck and strobila.
●Head/scolex: The scolex has 4 suckers and and a rostellum bearing single row of
20–30 hooklets.
● Neck: It is long and gives rise to proglottids.
● Strobila: consisting of 200 or more proglottids, which are much broader than long.
1
Egg:
● Eggs are the infective form as well as the diagnostic form of the parasite.
● Egg is round to slightly oval, 30–47 μm size.

● Colorless in saline mount.
● It has two membranes (outer egg shell and an inner embryophore) and an
oncosphere with six hooklets.
● Eggs are immediately infective when passed in faeces.
● Both the poles of embryophore are thickened from which four to eight polar
filaments emerge.
Larva
The larval form is called cysticercoids.
2
Life cycle
Two life cycles are noted, i.e. direct and indirect cycle.
Direct Cycle
Host: Man is the only host. There is no intermediate host. Rodents (rat and mice)
are the other hosts.
Infective form: Eggs
Mode of transmission: Man acquire the infection by:
♦ Ingestion of food and water contaminated with eggs
♦ Autoinfection with their own eggs released in the small intestine.
● In the small intestine, eggs hatch out, penetrate the intestinal wall and develops
into cysticercoid larvae in 4–5 days.
● Thereafter, the intestinal villi rupture and cysticercoids larvae become free in the
gut lumen and transform into the adult worms in 10–12 weeks.
● Adult worm, when fully mature undergoes fertilization to produce eggs.
● Eggs are passed in the feces which are infective to man.
● Though the adult worm lives only about 4–10 weeks, the infection persists due to
autoinfection.
Indirect Cycle
Host: Man is the definitive host. Insects act as intermediate host.
Mode of transmission: Man acquire the infection rarely, by accidental ingestion of
insects containing the cysticercoid larva.
In human intestine: The larva develops into adult worm in human small intestine
which then produces eggs that are passed in the feces.
In rat fleas: Eggs are ingested by the insects, embryo hatches out, penetrate the
intestine and develop into the larval stage cysticercoid larva in the insect’s body
cavity. This stage is infective to man.
3
Pathogenesis and Clinical Features
♦ Hymenolepiasis is usually asymptomatic but in heavy infections, patients may
present with nausea, anorexia, abdominal pain, diarrhoea and irritability.
♦ Anal pruritus may be due to an allergic response.
Laboratory Diagnosis
Microscopic examination
Detection of characteristic eggs in faeces.
Treatment
♦ Praziquantel (25 mg/kg once) is the drug of choice, since it acts against both the
adult worms and the cysticercoid larvae in the intestinal villi.
♦ Nitazoxanide (500 mg for 3 days) may be used as an alternative.
Prevention and Control

1. Personal hygiene
2. Proper sanitation
3. Avoid consumption of contaminated food and water by flea or beetles.
4. Rodent control
4
Hymenolepis diminuta
♦ Its common name is rat tapeworm and is a common parasite of rats and mice.
♦ It measures 10–60 cm in length.
♦ Its eggs are bigger than that of H. nana and it has no polar filaments.
♦ Its life cycle is similar to that of H. nana.
♦ Human infection follows accidental ingestion of infected rat fleas.
♦ Most infections are asymptomatic. Occasionally, patients may complain of mild
gastrointestinal symptoms.
Differences between H. nana and H. diminuta
Hymenolepis nana Hymenolepis diminuta

Common name Dwarf tapeworm Rat tape worm
Host Man is the only host, Rodents (or man) definitive host
occasionally insects act as and Insects are intermediate host
intermediate host
Life cycle Both direct and indirect cycle Only indirect cycle occurs, i.e.
always needs insects
Adult worm
Length Small (1–4 cm) Large (10–60 cm)
Scolex Bears four suckers with Bears four suckers, with
rostellum and hooklets rostellum but no hooklets
Proglottids 200 or more 800–1,000
Egg Smaller, 30–47 μm, polar Larger 60–80 μm polar filaments
filaments present absent
Human infection Common Rare Common Rare

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المحاضرة 5 مادة الطفيليات

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Hymenolepis nana & Hymenolepis diminuta

Dr. Talal Saeed Alwajeeh

● Egg is round to slightly oval, 30–47 μm size.

Prevention and Control

Differences between H. nana and H. diminuta

Hymenolepis nana Hymenolepis diminuta

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