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EndoTODAY 내시경 교실
[Taenia saginata. 무구조충]
무구조충 (Taenia saginata, beef tapeworm, 민촌충)은 충체 편절이 약 2,000개 이상으로 전체 길이는 12 m에 달할 수 있다. 많은 면에서 유구조충과 비슷하지만 중간숙주가 '소'인 점이 다르다. 국내에서 발견되는 유무구조충 감염자의 70-90%가 무구조충감염자이다. 대부분 별 증상이 없으며 편절이 빠져 나올 때 이물감, 항문소양증이 발생되고 드물게 장폐색 등이 가능하다. Praziquantel로 치료한다.
NEJM 임상화보 (2016)
A 38-year-old man presented with worsening abdominal pain, vomiting, anorexia, generalized weakness, and weight loss that had begun 3 days earlier. He had a history of eating raw beef. During the previous 2 years, he had been seen by several different doctors and had been given clinical treatment for stomachache, abdominal pain, and chronic anemia. Physical examination was largely unremarkable. Microscopic examination of stool showed an embryonated egg containing an oncosphere (Panel A). The patient was treated with praziquantel, administered orally at a dose of 60 mg per kilogram of body weight; approximately 40 minutes later, he received mannitol as a catharsis drug, administered orally at a dose of 300 ml in 20% aqueous solution. Two and one half hours after the administration of mannitol, the patient discharged a tapeworm that measured 6.2 m excluding the scolex (Panel B, arrow). A gravid proglottid was identified, with at least 23 lateral uterine branches on each side (Panel C) and a distinct genital pore containing a vaginal sphincter (Panel D, arrow). The patient received a diagnosis of Taenia saginata (beef tapeworm) infection. Humans become infected with T. saginata by ingesting cysticerci during consumption of raw or inadequately cooked beef. The tapeworm attaches to the small intestine and can grow to be several meters in length. Humans are the only definitive hosts. At a follow-up visit 3 months later, the patient was asymptomatic, with recovery of appetite and weight.
1) EndoTODAY 기생충학
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Jun Haeng Lee.