Tapeworm infestation: a cause of iron deficiency anemia shown by capsule endoscopy

Ultrasonographic findings of Diphyllobothrium nihonkaiense: A case report

A 6-year-old girl was admitted to our hospital due to discharging the strobila of a tapeworm (Diphyllobothrium nihonkaiense) from her anus. Before excreting the tapeworm completely with anthelmintics, ultrasonography was performed. The tapeworm was shown as a slightly high echoic strand-like lesion on ultrasonography in the terminal ileum. In this strand-like lesion, some high echoic spots were detected. This finding was considered as a characteristic of Diphylloborthriasis.

How tapeworm infection and consumption of a Cd and Zn hyperaccumulating plant may affect Cu, Fe, and Mn concentrations in an animal-a plant consumer and tapeworm host

This study evaluated the effects of a hyperaccumulator plant (Arabidopsis halleri), containing surplus of cadmium (Cd) and zinc (Zn) and being an admixture to the rat feed, on concentrations of copper (Cu), iron (Fe), and manganese (Mn) in the tissues of experimental rats infected/uninfected with the tapeworm (Hymenolepis diminuta). Male Wistar rats were divided into three groups (00, P0, and PT); the P0 and PT animals were fed a standard mixture for rats (ST-1) supplemented with the plant A. halleri at a weekly Zn and Cd dosage of 123 and 1 mg, respectively. Moreover, rats from the group PT were infected with the tapeworm. The group 00 served as control animals fed only ST-1 having no tapeworm infection. Rats were euthanized after 6 weeks, and Cu, Fe, and Mn levels were determined in rat and tapeworm tissues. The results indicated that both the consumption of hyperaccumulator plant and/or presence of tapeworms did have significant effect on Cu, Fe, and Mn concentrations in the host tissues. Concentrations of all the elements were higher in the rat liver and partially kidneys than in the tapeworms, and the concentrations of Cu, Fe, and Mn were affected by the consumption of Cd/Zn hyperaccumulator plants. Particularly, Fe concentrations in all rat tissues were significantly increased by consumption of A. halleri while decreased by the presence of tapeworms. Overall, the consumption of a Cd/Zn hyperaccumulator plant and tapeworm infection cause an imbalance in Cu, Fe, and Mn concentrations in the tissues of a consumer (experimental rats).

Taeniasis: A possible cause of ileal bleeding

Taenia spp. are flatworms of the class Cestoda, whose definitive hosts are humans and primates. Human infestation (taeniasis) results from the ingestion of raw meat contaminated with encysted larval tapeworms and is considered relatively harmless and mostly asymptomatic. Anemia is not recognized as a possible sign of taeniasis and taeniasis-induced hemorrhage is not described in medical books. Its therapy is based on anthelmintics such praziquantel, niclosamide or albendazole. Here we describe a case of acute ileal bleeding in an Italian man affected with both Taenia spp. infestation resistant to albendazole and Helicobacter pylori-associated duodenal ulcers.

Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

In vivo imaging of intestinal helminths by capsule endoscopy

This review examines the use of digestive endoscopy to visualize intestinal helminths. The infections caused by these parasites are responsible for high levels of morbidity and mortality. These helminths can be visualized using gastroduodenal endoscopy, endoscopic retrograde cholangiopancreatography, and colonoscopy. Endoscopic examination of the small bowel is limited by its considerable length and its distance from the mouth and anus. Since capsule endoscopy (CE) was first reported in 2000, it has been established as a noninvasive modality for the investigation of the gastrointestinal tract. CE is used as a first-line tool for imaging various small-bowel diseases, mainly obscure gastrointestinal bleeding and Crohn's disease. Since the Food and Drug Administration (FDA) approved CE in 2001, the indications for its use have expanded widely. For example, CE can be used to visualize the in vivo kinetics of intestinal helminths. If the current trends in technological development continue, CE will become more widely used to facilitate the diagnosis and treatment of helminth infections in the near future.

Capsule endoscopy is a feasible procedure for identifying a Diphyllobothrium nihonkaiense infection and determining the indications for vermifuge treatment

Diphyllobothrium is a member of Cestoda family, which is the largest parasite of humans. The diagnosis of diphyllobothriasis is based on the detection of eggs in the stool. Because the remainder of the scolex causes a relapse in diphyllobothriasis, the scolex must be completely discharged to cure the parasite infection. However, the scolex or forefront of the Diphyllobothrium is difficult to detect with gastroduodenoscopy and colonoscopy, because most Diphyllobothrium attach to the jejunal wall. In the present case, capsule endoscopy detected proglottids as well as forefront of the parasite at jejunum. Based on the results of capsule endoscopy, the patient underwent additional vermifuge (anthelminthic) treatment to cure the diphyllobothriasis and discharged a worm measuring 3 m in length with a scolex. Capsule endoscopy is a practical option to determine whether additional vermifuge treatment is required through the detection of the proglottids as well as a scolex or forefront of the parasite.