Submitted: 01 Oct 2016
Revised: 22 Oct 2016
Accepted: 22 Oct 2016
First published online: 15 Nov 2016
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Case Record of a Teaching Hospital in Karaj; A 35-Year Old Man With <em>Taenia saginata</em> Infection Treated With Niclosamide

Int J Enteric Pathog, 4(4), 9-37109; DOI:10.15171/ijep.2016.19

Case Report

Case Record of a Teaching Hospital in Karaj; A 35-Year Old Man With Taenia saginata Infection Treated With Niclosamide

Aliehsan Heidari1, Enayatollah Kalantar2 ,*, Parviz Fallah3, Mohammad Hossein Dehghan4, Sadegh Saedi5, Moniereh Sezavar3, Morteza Ghoghaee5

1 Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
2 Dietary Supplements and Probiotics Research Center, Alborz University of Medical Sciences, Karaj, Iran
3 Department of Hematology, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran
4 Department of Biochemistry, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
5 Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran

*Corresponding author: Department of Microbiology and Immunology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. Phone: 0098 26 34336009 Fax: 0098 26 34336009 Email: ekalantar@hotmail.com

Abstract

Taenia saginata can cause severe health and economic problems particularly in endemic areas . The disease cause by this cestode is related to poor sanitary conditions, inadequate hygiene, open defecation, inadequately cooked beef and poverty. A 35 years man found yellowish white tapeworm proglottids moving in his feces and consulted to the Department of Emergency, ShahidRajaei hospital, Karaj, Iran. He complained of lower abdominal discomfort, anal itching and moving something in the stomach. He was given wrong prescription. The patients had the history of eating undercooked beef. We report one case of T. saginata infection based on adult tapeworm recovery from the patients . The specific identification of the worm was based on based on standard procedures. Three months after expelling the tapeworm, the man felt better and returned to his normal life.


Keywords: Taenia saginata, Beef, parasitic infection

Introduction

Gastrointestinal infections caused by parasites present a significant burden for public health particularly in poor communities.1,2 Among parasitic infections, Taenia species infection, particularly, saginata is worldwide in distribution, causing taeniasis in humans and has the greatest economic and medical importance.3

It seems that taeniasis is still present in rural areas of Iran, due to lack of meat inspection systems and sustainable education against this kind of infection. Herein we report a case presented with abdominal pain and frequent excretion of intestinal worm which was finally diagnosed with the parasite Taenia saginata.

Case Presentation

A 35-year-old man, from a rural area in Karaj, Iran, referred to the emergency department of a teaching hospital in Karaj with features of something moving in the stomach, abdominal discomfort, and anal itching. He had the history of an on/off severe increasing abdominal pain for 8 years, nausea, easy agitation, passing proglottids of worms in the stool, and elicited a diet history of beef consumption. During the previous years, he had been seen by different physicians and had been given various treatments for stomachache and abdominal pain.

He had the following paraclinical test results on the day of admission: white blood cell (WBC) = 7000 cells/mm3 (neutrophil = 48.3%, lymphocyte = 47.2%, monocyte = 2.7%, eosinophil = 1.7%), red blood cell (RBC) = 5 700 000 cells/mm3, and hemoglobin (HB) = 15.4 gr/dL. Other biochemical tests were in normal range except for alanine aminotransferase (ALT) which was 54 IU/L (higher than normal range up to 40 IU/L). Similarly, sonography was taken from liver, bile ducts, and urinary system in which bile ducts’ slight inflammation was reported.

In this study, we reported a case of T. saginata infection based on an adult tapeworm recovery from the infection. The specific identification of the worm was based on standard procedures.4 Briefly, detection of Taenia species eggs was performed upon microscopic examination of stool sample (Figure 1). Six active proglottid chains were observed in stool. These gravid proglottides were mounted between two glass slides; then uterine lateral branches were counted. Proglottids were identified as T. saginata because there were 20 lateral uterine branches.

Figure 1. Ova of Taenia Excreted by Patient.

It is worth to note that the sonography of bile ducts revealed slight inflammation; however, HIV and HBS were suspected by physician. Therefore, firstly the physician prescribed the patient a panel of tests for HIV and HBS; though, all of them were negative.

As reported in other studies, increased ALT enzyme is related to bile duct inflammation; therefore, the rise of ALT enzyme in T. saginata infection could increase the ALT.5Finally, the patient was treated with niclosamide (2 g). At a follow-up visit 3 months later, the patient was asymptomatic, with recovery of appetite and other symptoms, and ova or proglottids were not seen in the stool sample.

By the way, taeniasis is one of the World Health Organization (WHO)-neglected parasitological diseases and continues as one of the public health burdens in most developing countries.6 Taeniasis refers to the intestinal infection with adult tapeworm, which is acquired by eating raw or undercooked beef or pork containing cysticerci.

In a study by Kia et al,7 the prevalence of T. saginata infection was reported to be 0.5%. According to this study, it was due to the consumption of inadequately cooked beef as a peculiar dietary habit. Our study was in line with the study of Kia et al.

Conclusion

To conclude, following the list of WHO on the interventions for control of taeniasis, the prevention, improved health education, improved sanitation, improved beef inspection, diagnosis processing, and appropriate treatment and follow-up of taeniasis cases are strongly recommended, as the patient explained: “being infected with a parasite for 8 years was a very unforgettable experience for me as it was physically, emotionally, and financially exhausting.”

Authors Contributions

AH and EK designed the study and wrote the article. SS and MS performed the experiments. MHD, PF and MG analyzed and interpreted the data.

Ethical Approval

Written informed consent was obtained from the patient for the publication of this report.

Conflict of Interest Disclosures

None.

Funding/Support

None.

Acknowledgments

This research would not have been feasible without the support of the patient’s family.

References

  1. Hotez PJ. Reducing the global burden of human parasitic diseases. Comp Parasitol 2002;69(2):140-145. doi:10.1654/1525-2647(2002)069[0140:rtgboh]2.0.co;2. [Crossref]
  2. Torgerson PR, Macpherson CN. The socioeconomic burden of parasitic zoonoses: global trends. Vet Parasitol 2011;182(1):79-95. doi:10.1016/j.vetpar.2011.07.017. [Crossref]
  3. Shafaghi A, Rezayat KA, Mansour-Ghanaei F, Maafi AA. Taenia: an uninvited guest. Am J Case Rep 2015;16:501. doi:10.12659/ajcr.892225. [Crossref]
  4. Flisser A. Taeniasis and cysticercosis due to Taeniasolium. Prog Clin Parasitol 1994;4:77.
  5. Liu YM, Bair MJ, Chang WH, Lin SC, Chan YJ. Acute pancreatitis caused by tapeworm in the biliary tract. Am J Trop Med Hyg 2005;73(2):377-80.
  6. Okamoto M, Wu Y, Raoul F, et al. Mini review on chemotherapy of taeniasis and cysticercosis due to Taeniasolium in Asia, and a case report with 20 tapeworms in China. Trop Biomed 2013;30(2):164-174.
  7. Kia EB, Masoud J, Yalda A, Mahmoudi M, Farahani H. Study on human taeniasis by administring anti-taenia drug. Iran J Public Health 2005;34(4):47-50.