A 35-year-old fisherman from Bihar presents with abdominal pain and passage of proglottids in stool. Proglottid examination shows more than 15 lateral uterine branches on each side. The most likely diagnosis and appropriate treatment are:
- A Taenia solium — praziquantel (avoid in neurocysticercosis risk) or niclosamide
- B Taenia saginata — praziquantel or niclosamide ✓
- C Diphyllobothrium latum — praziquantel or niclosamide
- D Hymenolepis nana — praziquantel
Explanation
Taenia saginata (beef tapeworm) proglottids have more than 15 lateral uterine branches (typically 15–35 per side), and the gravid proglottid is the key distinguishing feature from Taenia solium, which has fewer than 13 branches per side. T. saginata proglottids are also actively motile and can migrate out of the anus. T. saginata does not cause cysticercosis (unlike T. solium), so praziquantel is safe without risk of provoking neurocysticercosis. Niclosamide is an effective alternative. Treatment with praziquantel should be accompanied by repeat stool examination at 3 months to confirm cure.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.