A 48-year-old female farmer came to our outpatient department with mild anemia (Hb 7.1 mmol/L; Hct 33%) and a history of weight loss (current BMI 20.1 kg/m2). She reported “lots of small mobile structures about the size of a penny” in her feces and underwear. She denied having been abroad. Tapeworm segments (proglottids) were readily visible in a stool sample, and Taenia eggs were seen under the microscope (Figure). Based on the mobility of the proglottids and microscopic analysis of the worm uteri, beef tapeworm infestation (taeniasis caused by Taenia saginata) was diagnosed. Taeniasis is very rare in Germany due to the prevailing high standards of veterinary medical care and food hygiene. Infection of humans (the definitive host of T. saginata), usually asymptomatic, results from consumption of inadequately cooked beef containing cysticerci. Indeed, the patient reported a liking for beef carpaccio. She was successfully treated with a single dose of the anthelminthic praziquantel (10 mg/kg body weight; NB: benzimidazole preparations such as mebendazole are ineffective).
FIGURE.
Translated from the original German by David Roseveare.
Cite this as: Wendt S, Lippmann N, Lübbert C: Diagnosis at a glance: tapeworm infestation.
Footnotes
Conflict of interest statement:
The authors declare that no conflict of interest exists.