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PendidikanPendidikan
MagisterMagister KedokteranKedokteran TropisTropis
HY 1
DepartemenDepartemen ParasitologiParasitologi
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Clinical caseClinical case
Anda adalah dokter yang bertugas di di
salah satu Puskesmas di KabupatenSamosir. Suatu kali seorang pasien lelaki
sepotong benda berukuran sekitar1x0.5cm bewarna putih susu, kenyal dan
bergerak aktif di dalam celana dalamnya.
HY 2
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LearningLearning ObjectivesObjectives
1. Agent(s) of the disease
2. Nature of the disease
3. Risk factors
4. Complications5. Management: diagnosis, treatment,
prevention
HY 3
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MorphologyMorphology
TapeTape--likelike
SegmentedSegmented Scolex (head)Scolex (head)11
Strobila, divided into proglottidsStrobila, divided into proglottids
11
22
33
HY 5
Immature proglottidsImmature proglottids22
Mature proglottidsMature proglottids33
Gravid proglottidsGravid proglottids44
HermaphroditeHermaphrodite
Hooks and suckersHooks and suckers
GIT: nilGIT: nil
Body cavity absentBody cavity absent
44
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ClassificationClassification Intestinal cestodes:Intestinal cestodes:
Taenia saginataTaenia saginata
Taenia soliumTaenia solium
Hymenolepis nanaHymenolepis nana
HY 6
DiphyllobothriidaeDiphyllobothriidae
Zoonotic cestodes:Zoonotic cestodes: Echinococcus granulosusEchinococcus granulosus
Dypilidium caninumDypilidium caninum
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TaeniaTaenia sp.sp.
HY 7
TaeniaTaenia saginatasaginata
TaeniaTaenia soliumsolium
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Taenia saginataTaenia saginataBeef tapewormBeef tapeworm
Up to 1Up to 1--2k2kproglottidsproglottids
GravidGravid
HY 8
crawl out fromcrawl out fromanusanusvoluntarilyvoluntarily
Habitat: smallHabitat: smallintestineintestine
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Taenia saginataTaenia saginataLife cycleLife cycle
InfectiveInfectivestage:stage:
cysticercuscysticercusbovisbovis inincattle meatcattle meat
Route ofRoute of
HY 9
n ec on:n ec on:ingestioningestion
DxDx stage:stage:
eggs in feceseggs in fecesor anal swabor anal swab
gravidgravidsegmentssegments
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Taenia saginataTaenia saginataMorphologyMorphology
Scolex: 4 suckersScolex: 4 suckers
Gravid segment:Gravid segment: 1515--20 branches of20 branches of
uterusuterusAA
Genital ore: one ofGenital ore: one of
HY 10
each segment ineach segment inirregular siteirregular siteBB
EggEgg (viable up to 159 days)(viable up to 159 days)::
EllipticalElliptical
EmbryophoreEmbryophore (thick(thickshell with radial pattern)shell with radial pattern)
Content: hexacanthContent: hexacanthembryo (oncosphere)embryo (oncosphere)
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Taenia soliumTaenia soliumLife cycleLife cycle
InfectiveInfectivestage:stage:
cysticercuscysticercuscellulose incellulose inpork and orpork and oreggseggs
HY 11
ou e oou e oinfection:infection:ingestioningestion
DxDx stage:stage:
-- eggs in feces oreggs in feces or
swabswab-- cysticercuscysticercus
cellulose fromcellulose fromtissue biopsytissue biopsy
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Taenia saginataTaenia saginataLarvaLarva
CalledCalled cysticercuscysticercus
bovisbovis, no hooks, no hooks InvaginateInvaginate in cattlein cattle
muscles andmuscles and
HY 12
ssuesssues Ingested byIngested by
human,human, evaginateevaginatein small intestinein small intestineto become adultto become adultwormworm
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Taenia soliumTaenia soliumScolexScolex
Scolex: 4 suckers,Scolex: 4 suckers,
hooks, rostellumhooks, rostellum
HY 13
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Taenia soliumTaenia soliumEggsEggs
Resembles theResembles the
eggs ofeggs of TaeniaTaeniasaginatasaginata
HY 14
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Taenia soliumTaenia soliumStrobilaStrobila
Strobila:Strobila: 22--3 m long3 m long
less than 1k proglottidsless than 1k proglottids proglottid: less uterine branches (7proglottid: less uterine branches (7--1212
pairs)pairs)
HY 15
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Taenia soliumTaenia soliumLarvaLarva
CalledCalled cysticercuscysticercus
cellulosecellulose, six hooked, six hooked Habitat:Habitat:
humans muscles andhumans muscles and
HY 16
Pigs muscles and tissuesPigs muscles and tissues
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Taenia soliumTaenia soliumLarvaLarva
HY 17
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Clinical ManifestationsClinical Manifestations TaeniaTaenia soliumsoliummay cause cysticercosis. The
most severe cysticercosis is that which involveCNS (neurocysticercosis). Other sites arelungs, liver, and eyes.
Neurocysticercosis might cause meningitis,epilepsy, dementia, and can be fatal.
TaeniaTaenia saginatasaginatadoes not cause cysticercosis.
However, the voluntary excretion of thesegments might have the patients
uncomfortable and induce mental depression.
HY 18
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ManagementManagement
Diagnosis is based on QDP
(questionnaire of demonstrationproglottids). Though possible, its hard to
.
Cysticercosis is found through radiologicexamination
HY 19
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ManagementManagement The worms need to be expelled completely
from the intestine. We need to be sure that notonly have the proglottids, but also the scolexand neck been removed.
Laxatives to expel proglottids Niclosamide
Praziquantel 40mg/kgBW (single dose)
Surgery for the csticercosis.
HY 20
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SoSo
1. Agent(s) of the disease?
2. Nature of the disease?
3. Risk factors?
4. Complications?5. Management: diagnosis, treatment,
prevention?
HY 21
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HY 22