BEEFT TAPE WORM DISEASE : CLINICAL ASPECTS
Most infected patients are asymptomatic and become aware of the infection only through the spontaneous passage of proglottids.
The proglottids may be observed on the surface of the stool or appear in the underclothing or bed sheets of the alarmed host. Passage may occur very irregularly and can be precipitated by excessive alcohol consumption. Some patients report epigastric discomfort, nausea, irritability (particularly after passage of seg-ments), diarrhea, and weight loss. Occasionally the proglottids may obstruct the appen-dix, biliary duct, or pancreatic duct.
The diagnosis is made by finding eggs or proglottids in the stool. Eggs may also be dis-tributed on the perianal area secondary to rupture of proglottids during anal passage. The adhesive cellophane tape technique described for pinworm can be used to recover them from this area. With this procedure, 85 to 95% of infections are detected, in contrast to only 50 to 75% by stool examination. Because the eggs of T. solium and T. saginata are morphologically identical, it is necessary to examine a proglottid to identify the species correctly.
The drugs of choice are praziquantel or niclosamide, which act directly on the worm. Both are highly effective in single-dose oral preparations. Ultimately, control is best effected through the sanitary disposal of human feces. Meat inspection is helpful; the cysticerci are readily visible. In areas where the infection is common, thorough cooking is the most practical method of control. Internal temperatures of 56°C or more for 5 minutes or longer destroy the cysticerci. Salting or freezing for 1 week at _15°C or less is also effective.