Hymenolepis diminuta Infection in a Child Living in the Urban Area of Rome, Italy

Abstract

We report a case of Hymenolepis diminuta infection in an Italian child affected by tuberous sclerosis. Praziquantel is the drug of choice for the treatment of H. diminuta infection. However, considering the patient's neurological disease, we decided to use not praziquantel but niclosamide, which proved equally effective. CASE REPORTA 2-year-old boy living in the urban area of Rome, Italy, was referred to the Department of Tropical and Infectious Diseases of the University of Rome "La Sapienza" owing to the emission of tapeworm proglottids in his stool. In the previous 2 weeks, the patient had episodes of itching and nocturnal restlessness. His medical history was positive for tuberous sclerosis with no overt neurological complications other than seizures that were controlled with diazepam. The results of a physical examination were normal. No abnormalities were revealed by blood and urine analyses. Macroscopic and microscopic tapeworm examinations were suggestive of Hymenolepis diminuta proglottids. The parasitological examination of concentrated stool samples revealed spherical eggs, 70 m in diameter, with a striated outer membrane and a thin inner membrane and containing six central hooklets but no polar filaments (Fig. 1); they were identified as H. diminuta eggs and differentiated from H. nana eggs, which have a similar appearance but are smaller and have two evident polar thickenings, from each of which arise four to eight polar filaments. Owing to the possible convulsant effect of praziquantel, oral niclosamide (1 g for the first day, 500 mg/day for the following 6 days) was prescribed (1, 3). Parasitological stool examinations 7, 9, 15, and 30 days after the end of treatment were negative for H. diminuta eggs.

A Rare Case of Hymenolepis diminuta Infection in a Small Child

“…Bildirilen olgular çoğunlukla çocuk olmasına rağ-men, hastalık tüm yaş gruplarında ve her iki cinsiyette de görülebilmektedir 7 . İnsanlarda H.diminuta enfeksiyonları H.nana'ya göre daha nadir görülmektedir; zira H.nana ara konağa ihtiyaç duymamakta ve insandan insana direkt olarak bulaşabilmektedir 1,3 . Dolayısıyla dünya çapında H.diminuta ile ilgili olgu sunuları oldukça azdır 3 .…”

“…Hymenolepis nana'dan farklı olarak yaşam döngüsünde ara konak olarak artropodlar yer almaktadır; dolayısıyla H.nana direkt olarak insandan insana bulaşabilirken, H.diminuta bulaşamamaktadır. Yumurtalar artropodlar tarafından alındığı zaman sistiserkoid dönem oluşmaktadır 2,3 . Sistiserkoid larvaların oluşabilmesi için ara konak görevi gören böcek, pire, tırtıl gibi yirmiden fazla koprofilik artropod türü bulunur ve bu artropodların en önemlileri güve ve buğday kurdudur 4 .…”

Helminth fauna and zoonotic potential of the European hamster Cricetus cricetus Linnaeus, 1758 in agrobiocoenoses from Vojvodina province (Serbia)

“…Thus, it will be excluded from any further discussion, with our attention now shifting to the tapeworm species and their epidemiological signifi cance. Hymenolepis diminuta has been confi rmed to infect humans, with recent data coming from rather unexpected places such as Spain (Tena et al, 1998) and Italy (Marangi et al, 2003), two European countries with high healthcare and hygiene standards. However, infection is uncommon and occasional, with children as the most likely hosts, certainly due to their less rigorous hygienic practices (Levi et al, 1987;Hamrick et al, 1990;Varghese et al, 1998).…”

Sustainable farming of the mealworm Tenebrio molitor for the production of food and feed

“…The parasite develops in the host's hemocoel and inhibits its reproductive success [60,61]. Infected mealworms consumed by the definitive host (usually rodents, but also livestock and humans) thus transmit the parasite, resulting in enteritis, anorexia and gut irritation [62,63]. The single-cell parasite Gregarina niphandrodes primarily infects arthropods, and although the infection of mealworms does not influence the population dynamics, it does reduce the lifespan of the adult beetle [64,65].…”