Cysticercosis

　　The adult sparganum tapeworm has a similar appearance and structure to the man-sized sparganum tapeworm, but the worm is larger, up to 10 meters long, the widest part being 20 mm, with 3000 to 4000 segments. The cephalic segment has a narrow and deep groove on both the dorsal and ventral sides, with the male genital pore and the vaginal orifice opening together at the anterior ventral reproductive cavity of the segment. The eggs are nearly oval, 55 to 76 μm long, 41 to 56 μm wide, light gray-brown in color, with a thick eggshell and a distinct egg cover at one end and a small spine at the other.

　　The life cycle of the wide-belt sparganum is similar to that of the man-sized sparganum. The difference lies in the second intermediate host, which is fish, with humans as the main definitive host. The adult tapeworms parasitize in the small intestines of carnivorous animals such as humans, dogs, cats, bears, foxes, and pigs.

　　Most sparganosis is caused by a single tapeworm in the human body, but there may also be 2 to 3, or even up to a dozen. The cyst wall is composed of granulation tissue, with a large number of eosinophils, interspersed with epithelioid cells and foreign body giant cells. The outermost layer of the cyst wall is fibrous tissue.

　　The larvae in the human body still maintain the larval state and have migratory characteristics. After entering the intestine, the larvae adhere to the intestinal mucosa, their heads extending into the submucosal layer until穿透 the intestinal wall and entering the peritoneal cavity; upwards, they can penetrate the diaphragm into the thoracic cavity; downwards, they can penetrate the abdominal wall and migrate between the subcutaneous tissue and muscles, causing inflammation, infiltration of eosinophils, and finally forming eosinophilic granulomas. Sometimes the larvae move upwards along the carotid artery, enter the intracranial cavity through the foramen magnum, and cause cerebral sparganosis.

　　Important complications of sparganosis include:

　　1. Biliary obstruction and intestinal perforation. Biliary obstruction refers to the worm migrating to the bile duct, causing obstruction and leading to lesions. Intestinal perforation is a disease caused by the worm adhering to the intestinal wall, leading to necrosis and eventually perforation.

　　2. Sometimes the larvae move upwards along the carotid artery, enter the intracranial cavity through the foramen magnum, and cause cerebral sparganosis.

　　Most infected individuals with sparganosis show no obvious symptoms, or have mild symptoms such as fatigue, weakness, numbness in the limbs, diarrhea or constipation, hunger, and a craving for salt. Sometimes, the worm may twist into a ball, causing intestinal or bile duct obstruction, even leading to intestinal perforation, etc. About 2% of patients with wide-belt sparganosis have megaloblastic anemia.

　　The main preventive measures for sparganosis are public education and propaganda. Changes in unhygienic habits of eating fish, such as not eating raw or undercooked fish. Strengthening the management of animals such as dogs and cats to avoid fecal contamination of rivers and lakes. Other preventive measures include:

　　1. The control of the infectious source should be conducted through general surveys and treatments in the epidemic area, including the treatment of patients and carriers.

　　2. Strengthen faecal management, pay attention to the cleanliness of pastures, avoid human feces contaminating the water source of pastures, and avoid cows being infected. Strengthen the breeding management of cows, and in order to prevent cows from being infected, the toilet and cowshed should be separated to prevent cows from eating human feces.

　　3. Strengthen health education, pay attention to personal hygiene, improve dietary and hygiene habits, meat must be well-cooked, and the knives and chopping boards used to cut raw and cooked vegetables should be separated, and they should be cleaned after use to prevent contamination.

　　4. Strengthen meat inspection, ban the sale of beef containing cysticerci. Strengthen the supervision and management of abattoirs, strictly prohibit the sale of beef containing tapeworm larvae.

　　The laboratory tests needed for the diagnosis of sparganosis include:

　　1. The number of white blood cells in the blood count does not change greatly, but there is a slight increase in the number of eosinophils.

　　2. Bone marrow examination and special examinations (such as vitamin B12 and folic acid determination, vitamin B12 absorption test, etc.) can confirm megaloblastic anemia.

　　3. The worm can be found in subcutaneous masses and eyelid nodules by histological examination. Or the examination shows eosinophilic granuloma, and whether there is a lesion can be judged from the cross-section of the worm.

　　4. Faecal examination can detect eggs in the patient's feces.

　　For sparganosis, attention should be paid to diet: eating more meat and fresh green leafy vegetables to increase the intake of vitamin B12 and folic acid. The patient's diet should be light and easy to digest, with more fruits and vegetables, a reasonable diet, and attention to sufficient nutrition. In addition, patients should also pay attention to avoiding spicy, greasy, and cold foods.

　　The Western medicine treatment for sparganosis mainly includes taking anthelmintic drugs, as follows:

　　Pyrantel 25mg/kg taken in a single dose. Chlor硝硫胺 (灭绦灵), mebendazole (甲苯咪唑), albendazole (丙硫咪唑) and others have anthelmintic effects.

　　After the worm is excreted, anemia can heal spontaneously. Severe anemia can be treated with intramuscular vitamin B12 injection. Vitamin and folic acid supplementation; the former is injected intramuscularly with 500-1000 micrograms per week (2-4 weeks) continuously for several weeks, and then 500-1000 micrograms are injected intramuscularly every month; the latter is taken orally at 15-30 mg per day, and 2-4 weeks constitute a course of treatment.