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Rare Tapeworm Infection due to Dipylidium caninum: Case Report


Rare Tapeworm Infection due to Dipylidium caninum: Case Report

Dr.Catherine A. Hogan, and Dr. Hayden Schwenk, at Stanford University School of Medicine, Stanford, CA  have reported a rare case of Dipylidium caninum Infection. The case has appeared in the New England Journal of Medicine.

Dipylidium caninum is a tapeworm that can cause intestinal infection, which is typically asymptomatic. This parasitosis occurs in dogs and cats, and occasionally in human beings, in the latter case, it is usually identified in children 1 to 5 years old. Fleas are the intermediate host. Ingestion of an infected flea, usually by a young child, causes an asymptomatic, self-limited infection, but proglottids (tapeworm segments) may be seen in the stool.

Treatment is with a single oral dose of praziquantel 5 to 10 mg/kg. Alternatively, a single 2-g dose of niclosamide (unavailable in the US) is given as 4 tablets (500 mg each) that are chewed one at a time and swallowed. For children, the dose is 50 mg/kg (maximum 2 g) once.

According to history, a  2-year-old girl presented to the pediatric infectious disease clinic with visible worms in the stool and mild perianal pruritus. Tests for ova and parasites in the stool were initially negative. The patient’s mother reported that several pet cats in the household were passing similar worms and had been treated empirically by a veterinarian. The patient’s mother brought a freshly passed proglottid in a sterile container filled with saline for further assessment.

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Courtesy NEJM

Microscopic examination of the proglottid confirmed the presence of egg packets that were diagnostic of the tapeworm Dipylidium caninum on both wet mount (Panel A) and iodine staining (Panel B). D. caninum infection typically occurs in dogs and cats but may occur in humans after ingestion of an adult flea harboring an infective cysticercoid, particularly in children living in close proximity to infected dogs or cats. The patient was treated with a single dose of praziquantel. At follow-up 3 weeks later, the perianal pruritus had resolved, and there was no recurrence of proglottids in the stool.

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For further reference log on to DOI: 10.1056/NEJMicm1813985




Source: With inputs from New England Journal of Medicine

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