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Taenia solium, Molecular Detection

Molecular testing for pork tapeworm (Taenia solium) in stool is used for the diagnosis and laboratory documentation of taeniasis.

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Pork tapeworm (Taenia solium) is one of the species of tapeworm parasitizing vertebrates in the gastrointestinal tract, including humans. The length of its body can reach up to 4 meters. It is distinguished from a beef tapeworm by the presence of hooks and suction cups on its head enabling it to attach to the wall of the host's small intestine. The body of a tapeworm consists of several hundred identical proglottids. The tapeworm development cycle is complex, and requires two hosts: intermediate and definitive. In the case of the pork tapeworm, the intermediate host is the domestic pig or the wild boar, the definitive host usually being a human. After the intermediate host has eaten tapeworm eggs excreted with faeces by the definitive host, the larva develops, which after being harbored encapsulates to take on the form of a cysticercus. After eating raw or undercooked/unfried pork, a cysticercus enters the human gastrointestinal tract. Clinical symptoms of tapeworm infection are non-specific and include digestive disorders, abdominal pain, appetite disorders, headaches, nausea, and disorders of the nervous system.

Tapeworm infection is called taeniasis and its course is generally mild. However, it can lead to the development of cysticercosis, which attacks the eyes or the nervous system. Cysticercosis is usually asymptomatic unless larvae invade the central nervous system, resulting in neurocysticercosis, which can cause seizures and various other neurologic signs. Neurocysticercosis may be recognized in brain imaging studies. Fewer than half of patients with neurocysticercosis have adult T. solium in their intestines and thus eggs or proglottids in their stool.

Intestinal infection with adult T. solium worms can usually be diagnosed by microscopic examination of stool samples and identification of ova and/or proglottids. However, the ova are indistinguishable from those of T. saginata and T. asiatica. T. solium eggs are present in ≤ 50% of stool samples from patients with cysticercosis.

Molecular testing of feces for the presence of the tapeworm Taenia solium DNA using the real-time PCR (RT-PCR) technique is the fastest, most sensitive, and most effective method for detecting the parasite.

Adult worms can be eradicated with praziquantel or niclosamide. Treatment of symptomatic neurocysticercosis is complicated.

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