There are many types of tapeworm disease (taeniasis), with the most common being those caused by pork tapeworms and beef tapeworms in the human small intestine. When humans consume undercooked pork or beef containing tapeworm larvae (cysticerci), the cyst's capsule is digested, and the scolex attaches to the intestinal wall. The neck segments gradually divide into a series of proglottids, developing into adult worms over 3–4 months, resulting in tapeworm disease. Humans are not only the definitive hosts for beef tapeworms and pork tapeworms but also the intermediate hosts for pork tapeworms. If fertilized eggs of pork tapeworms are ingested, the larvae (oncospheres) inside the eggs penetrate the intestinal wall and migrate to various sites outside the intestines (such as the brain, eyes, muscles, or subcutaneous tissue), developing into cysticerci and causing cysticercosis (cysticerosis). In China, the infection rate of short-membrane-shell tapeworms is higher in children than in adults because they can cause long-term, repeated self-infection in humans without requiring an intermediate host, making recovery difficult. The treatment is the same as for pork tapeworms or beef tapeworms.

bubble_chart Clinical Manifestations

1. Tapeworm disease occurs after consuming undercooked pork or beef, with the worms developing into adults in about 3 to 4 months. Most patients have a single worm infection, but severe cases may involve 3 to 5 Chinese Taxillus Herb worms simultaneously. Worm segments are often found in the stool or may crawl out of the anus. Symptoms in children may include abdominal pain, diarrhea, indigestion, weight loss, dizziness, and lack of strength.
2. Cysticercosis is caused by the pork tapeworm, and symptoms vary depending on the location and number of cysts. Cerebral cysticercosis is the most severe, potentially causing seizures, increased intracranial pressure, mental disturbances, ataxia, and even vision impairment, optic nerve atrophy, blindness, or cranial nerve paralysis. Subcutaneous or muscular cysticercosis may present with less obvious symptoms, such as palpable nodules under the skin, which may undergo fibrosis or calcification over time. Ocular cysticercosis can occur in any part of the eye and may lead to blindness if left untreated.

bubble_chart Auxiliary Examination

1. White proglottids or tapeworm eggs can be found in the feces. For beef tapeworm, the positive rate of egg detection using anal swabs is higher than that in feces.
2. Peripheral blood eosinophils may show grade I elevation.
3. Biopsy of subcutaneous and muscle tissues revealing cysticerci with scolex in the cysts can confirm cysticercosis. In chronic cases where the cysticerci have died, local X-rays may show calcified lesions.
4. For cerebral cysticercosis, electroencephalography (EEG) and cranial CT or MRI scans can be performed.

bubble_chart Treatment Measures

(1) Tapeworm Disease Treatment

1. Niclosamide: This drug destroys the scolex and proximal segments of the worm upon contact, causing the scolex to detach from the intestinal wall and be expelled. The dosage is 0.5g/day for children under 2 years old, 1g/day for ages 2–6, and 2g/day for those over 6, divided into two doses taken on an empty stomach with a 1-hour interval. Two hours after administration, 30–40ml of 50% magnesium sulfate can be taken as a laxative. For treating short membrane tapeworms, the dosage is 60–80mg/(kg·d), taken once daily for 5–7 days.
2. Areca Seed and Cushaw Seed Combination Therapy: Areca Seed has a paralyzing effect on the scolex and anterior segments of tapeworms, particularly effective against pork tapeworms. Cushaw Seed paralyzes the middle and posterior segments, so combining the two ensures the entire worm is paralyzed and expelled. Method of administration: Chew and swallow 30–60g of Cushaw Seed on an empty stomach in the morning. Two hours later, take a decoction of Areca Seed (30g boiled in water for 1 hour to yield 100–150ml). Half an hour later, take 30–40ml of 50% magnesium sulfate as a laxative. Typically, the intact worm is expelled within 3 hours.
3. Bithionol: Paralyzes the worm for expulsion, but segments may release eggs in the intestines or cause cysticercosis if vomiting occurs, so use with caution. Alternatively, take a small dose of chlorpromazine before administration to prevent nausea and vomiting.
4. Mebendazole: Dosage is 200mg per dose, 1–2 times daily for 3–4 days.
5. Albendazole: Dosage is 400mg per dose, once daily for 3 days.
6. Praziquantel: Dosage is 5–10mg/kg, taken once on an empty stomach. Use with caution in patients with heart disease or abnormal liver function.

AD

TCM can effectively treat dry eye syndrome, floaters, retinopathy, and various chronic eye diseases

1. After taking vermifugal medication, sit quietly on a bedpan filled with warm water at body temperature. Do not pull on expelled segments to avoid worm contraction and incomplete expulsion.
2. Collect all feces for 24 hours after taking vermifugal medication to check if the scolex has been expelled.
3. If the scolex is not found, follow up for 3–6 months to monitor for recurring segments or eggs. Repeat deworming if recurrence occurs.

For cerebral cysticercosis, in addition to symptomatic treatment (e.g., anticonvulsants, intracranial pressure reduction), praziquantel can be used at a daily dose of 20–30mg for 4–6 days, totaling 120mg. Surgical intervention is an option if the lesion is precisely localized.

bubble_chart Prevention

1. Thoroughly treat the patient.
2. Strengthen personal hygiene, dietary hygiene, and environmental hygiene.
3. Enhance meat management, with special attention to avoiding undercooked pork and beef.