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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3181c992a8
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Taeniasis in an Adolescent With Chronic Anemia

Harpavat, S*; Hicks, MJ; Chumpitazi, BP*

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*Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition, USA

Department of Pathology, Baylor College of Medicine, Houston, TX, USA

Received 8 October, 2009

Accepted 22 October, 2009

Address correspondence to Bruno Chumpitazi, MD, MPH, 6701 Fannin St, CCC 1010.02, Baylor College of Medicine, Houston, TX 77030 (e-mail: chumpita@bcm.edu).

The authors report no conflicts of interest.

Submissions for the Image of the Month should include high-quality TIF endoscopic images of unusual or informative findings. In addition, 1 or 2 other associated photographs, such as radiological or pathological images, can be submitted. A brief description of no more than 200 words should accompany the images. Submissions are to be made online at www.jpgn.org, and will undergo peer review by members of the NASPGHAN Endoscopy and Procedures Committee, as well as by the Journal.

A 13-year-old female with chronic iron-deficiency anemia was referred for guaiac-positive stools. After a negative medical workup, including ova and parasite evaluations, an esophagogastroduodenoscopy and colonoscopy were performed.

A long, white worm was found in the terminal ileum (Fig. 1). It was biopsied after attempts at its removal were unsuccessful. Histopathology demonstrated tissue with a thick outer cuticle housing refractile objects in dedicated compartments (Fig. 2). A diagnosis of taeniasis was made. The patient received praziquantel, and her guaiac-positive stools resolved.

Figure 1
Figure 1
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Figure 2
Figure 2
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Humans ingest cysticerci of Taenia saginata (beef) and Taenia solium (pork) through undercooked meat. The cysticerci develop into tapeworms that attach to the intestinal wall via a scolex and develop proglottids that extend distally. Proglottids and eggs are defecated, allowing cows or pigs to ingest them and continue the life cycle (1). Praziquantel is an effective therapy for intestinal tapeworms (2).

Taeniasis is a rare cause of chronic anemia within the United States, affecting approximately 0.1% of the US population. It is more common in parts of Latin America, Asia, and Africa (3). Infection is often asymptomatic, but blood loss and anemia have been reported (4,5). Systemic cysticercosis may occur with T solium infections.

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REFERENCES

1. Schantz PM. Tapeworms (cestodiasis). Gastroenterol Clin North Am 1996; 25:637–653.

2. van den Enden E. Pharmacotherapy of helminth infection. Expert Opin Pharmacother 2009; 10:435–451.

3. Kappus KD, Lundgren RG Jr, Juranek DD, et al. Intestinal parasitism in the United States: update on a continuing problem. Am J Trop Med Hyg 1994; 50:705–713.

4. De Simone P, Feron P, Loi P, et al. Acute intestinal bleeding due to Taenia solium infection. Chir Ital 2004; 56:151–156.

5. Vuylsteke P, Bertrand C, Verhoef GE, et al. Case of megaloblastic anemia caused by intestinal taeniasis. Ann Hematol 2004; 83:487–488.

© 2010 Lippincott Williams & Wilkins, Inc.

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