Taenia Saginata in Third-Generation Capsule Endoscopy

Abstract

A 60-year-old woman presented with chronic abdominal pain and iron deficiency anemia (hemoglobin, 9.8 g/dL; ferritin, 8 μg/L). The patient was white, born in France, and had never traveled outside France. Initial endoscopic evaluation, with gastroscopy and colonoscopy, was normal. Gastroduodenal biopsies were also normal. Small bowel capsule endoscopy (Pillcam SB-III, Medtronic, Dublin, Ireland) diagnosed a Taenia saginata infection. The worm was found from the proximal jejunum, where young immature proglottids consisting of a chain of small segments wider than long were visible (Figure A). Then, the segments grow and stretch out gradually to become mature proglottids (Figure B). This Taenia was extended until the terminal ileum with gradual appearance of gravid proglottids, measuring about 20 mm long and 6 mm wide (Figure C and D). Mature and gravid proglottids are the reproductive structures of this hermaphrodite parasite; with inside male and female structures. On our images, some of these sexual structures are visible, in particular on the last gravid proglottids, with multiple lateral uterine branches (Figure C, blue arrow) and uterus (Figure D, black arrow). The parasite was visible on 75% of the transit time in the small bowel, estimating a size of 2–3 m. The prognosis was favorable after eradication of the Taenia by a single dose of praziquantel. On the Visual Diagnosis of Human Taeniasis by Capsule EndoscopyClinical Gastroenterology and HepatologyVol. 16Issue 7PreviewLe Mouel et al1 recently identified a case of human taeniasis caused by Taenia saginata by means of third-generation capsule endoscopy. The authors of the article provide 4 illustrative images of the tapeworm and, specifically, gravid proglottids containing a branched uterus are shown. Because after endoscopy no additional confirmatory diagnostic method is specified, we reckon that the images of this branched uterus were meaningful enough for the specific tapeworm identification. Capsule endoscopy is a diagnostic method with high sensitivity. Full-Text PDF