Diagnosis

To diagnose a tapeworm infection, your doctor may rely on one of the following:

  • Stool sample analysis. For an intestinal tapeworm infection, your doctor may check your stool or send samples to a laboratory for testing. A laboratory uses microscopic identification techniques to check for eggs or tapeworm segments in your feces.

    Because the eggs and segments are passed irregularly, the lab may need to collect two to three samples over a period of time to detect the parasite. Eggs are sometimes present at the anus, so your doctor may use a piece of transparent adhesive tape pressed to the anus to collect eggs for microscopic identification.

  • Blood test. For tissue-invasive infections, your doctor may also test your blood for antibodies your body may have produced to fight tapeworm infection. The presence of these antibodies indicates tapeworm infestation.
  • Imaging exam. Certain types of imaging, such as CT or MRI scans, X-rays, or ultrasounds of cysts, may suggest invasive tapeworm infection.

Treatment

Some people with tapeworm infections never need treatment, for the tapeworm exits the body on its own. Others don't realize they have it because they have no symptoms. However, if you're diagnosed with intestinal tapeworm infection, medication will likely be prescribed to get rid of it.

Treatments for intestinal infections

The most common treatment for tapeworm infection involves oral medications that are toxic to the adult tapeworm, including:

  • Praziquantel (Biltricide)
  • Albendazole (Albenza)
  • Nitazoxanide (Alinia)

Which medication your doctor prescribes depends on the species of tapeworm involved and the site of the infection. These drugs target the adult tapeworm, not the eggs, so it's important to avoid reinfecting yourself. Always wash your hands after using the toilet and before eating.

To be certain that your tapeworm infection has cleared, your doctor will probably have your stool samples checked at certain intervals after you've finished taking your medication. Successful treatment — meaning that your stool is free of tapeworm eggs, larvae or proglottids — is most likely if you receive appropriate treatment for the type of tapeworm causing your infection.

Treatments for invasive infections

Treating an invasive infection depends on the location and effects of the infection.

  • Anthelmintic drugs. Albendazole (Albenza) can shrink some tapeworm cysts. Your doctor may monitor the cysts periodically using imaging studies such as ultrasound or X-ray to be sure the drug is effective.
  • Anti-inflammatory therapy. Dying tapeworm cysts can cause swelling or inflammation in tissues or organs, so your doctor may recommend prescription corticosteroid medication, such as prednisone or dexamethasone, to reduce inflammation.
  • Anti-epileptic therapy. If the disease is causing seizures, anti-epileptic medications can stop them.
  • Shunt placement. One type of invasive infection can cause too much fluid on the brain, called hydrocephalus. Your doctor may recommend placing a permanent tube (shunt) in your head to drain the fluid.
  • Surgery. Whether cysts can be removed surgically depends on their location and symptoms. Cysts that develop in the liver, lungs and eyes are typically removed, since they can eventually threaten organ function.

    Your doctor might recommend a drainage tube as an alternative to surgery. The tube allows aggressive rinsing (irrigation) of the area with anti-parasitic solutions.

Preparing for your appointment

For a tapeworm infection, you might first see your primary physician. However, in some cases, he or she may refer you to a doctor who specializes in infectious diseases or a doctor who specializes in disorders of the gastrointestinal tract (gastroenterologist).

Here's some information to help you get ready for your appointment, and what you can expect from your doctor.

What you can do

  • Write down the symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any recent travel, especially to other countries. Tell your doctor if you believe you've been exposed to food or water contaminated with tapeworm.
  • Make a list of all medications, vitamins and supplements you're taking.
  • Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. For tapeworm infection, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there other possible causes?
  • What kinds of tests do I need, if any?
  • What treatments are available and which do you recommend?
  • Are there any dietary restrictions that I need to follow?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask that you bring a stool sample to your appointment for testing. Your doctor may also ask you questions about your condition, such as:

  • When did your symptoms begin?
  • How severe are your symptoms?
  • Does anything seem to improve your symptoms?
  • Does anything make your symptoms worse?
  • Have you traveled recently? To what areas?
  • Could you have been exposed to food or drink contaminated with tapeworm?

What you can do in the meantime

While you're waiting to see your doctor, try to stay well-hydrated.

Dec. 15, 2017
References
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  2. Ferri FF. Tapeworm infestation. In: Ferri's Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Sept. 2, 2017.
  3. Leder K, et al. Intestinal tapeworms. https://www.uptodate.com/contents/search. Accessed Sept. 2, 2017.
  4. Goldman L, et al., eds. Cestodes. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Sept. 2, 2017.
  5. Parasites and foodborne illness. U.S. Department of Agriculture. https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/foodborne-illness-and-disease/parasites-and-foodborne-illness/CT_Index. Accessed Sept. 27, 2017.
  6. Overview of tapeworm infections. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/cestodes-tapeworms/overview-of-tapeworm-infections#v1015102. Accessed Sept. 27, 2017.
  7. Diphyllobothrium latum (and other species) FAQs. Centers for Disease Control and Prevention. https://www.cdc.gov/parasites/diphyllobothrium/faqs.html. Accessed Sept. 27, 2017.