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Tapeworm infection

Evidence last reviewed: 2 Jul 2026
Topic last updated: 30 Jan 2026

Summary

Definition

History and exam

Key diagnostic factors

  • worm segments in stool
  • increased intracranial pressure
  • seizures
  • hepatomegaly
  • cough
  • hemoptysis
  • chest pain
  • allergy manifestations
  • signs of anemia
Full details

Other diagnostic factors

  • asymptomatic
  • vague intestinal symptoms
  • sleep disturbance
  • headaches
  • rash
  • subcutaneous nodules
  • signs of sepsis
  • right upper quadrant/epigastric pain
  • dyspnea
  • heart palpitations
  • visual disturbances
Full details

Risk factors

  • living on farms
  • poor hygiene
  • eating or handling undercooked meat
  • eating or handling undercooked fish or crustaceans
  • ingestion of contaminated water
  • dog owners
  • outdoor pursuits
  • age <12 years
Full details

Diagnostic tests

1st tests to order

  • stool exam
  • complete blood count
  • enzyme-linked immunoelectrotransfer blot (EITB)
  • echinococcus enzyme-linked immunosorbent assay (ELISA) and Western blot serology
  • abdominal/thoracic ultrasound
  • MRI of chest/abdomen
  • echocardiogram
  • CT of brain
  • MRI of brain/spine
Full details

Tests to consider

  • screening for tuberculosis and strongyloidiasis
Full details

Treatment algorithm

INITIAL

central nervous system disease: with elevated intracranial pressure

ACUTE

intestinal disease

central nervous system disease: without elevated intracranial pressure

hepatic or thoracic disease

Contributors

Authors

Jose A. Serpa, MD, MS, PhD

Professor of Medicine

Division of Infectious Diseases, Department of Medicine

University of Texas at Tyler

Tyler

TX

Disclosures

JAS declares that he has no competing interests.

Acknowledgements

Dr Jose A. Serpa would like to gratefully acknowledge Dr Andrew Chou, Dr Christina Coyle, and Dr Maheen Saeed, previous contributors to this topic.

Disclosures

AC and MS declare that they have no competing interests. CC is an author of several references cited in this topic.

Peer reviewers

William A. Petri, Jr, MD, PhD, FACP

Chief and Professor of Medicine

Division of Infectious Diseases and International Health

University of Virginia Health System

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Linda Kalilani, MBBS, MPhil, PhD

Epidemiologist

College of Medicine

University of Malawi

Zomba

Malawi

Disclosures

LK declares that she has no competing interests.

Paul Roberts, MD

Assistant Professor

Family Medicine

Mayo Clinic

Jacksonville

FL

Disclosures

PR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization. WHO guidelines for the treatment of patients with cystic echinococcosis. Jun 2025 [internet publication].Full text

White AC Jr, Coyle CM, Rajshekhar V, et al. Diagnosis and treatment of neurocysticercosis: 2017 clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis. 2018 Apr 3;66(8):e49-75.Full text  Abstract

World Health Organization. ​WHO guidelines on management of Taenia solium neurocysticercosis. Sep 2021 [internet publication].Full text

Del Brutto OH, Nash TE, White AC Jr, et al. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci. 2017 Jan 15;372:202-10.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Tapeworm infection images
  • Differentials

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  • Guidelines

    • CDC Yellow Book: health information for international travel - post-travel parasitic disease including evaluation of eosinophilia
    • WHO guidelines for the treatment of patients with cystic echinococcosis
    More Guidelines
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