A neglected zoonotic helminth—Hymenolepis nana, fatal in the pediatric population—an incidental finding

This is a medicolegal case of a deceased pediatric patient infected with Hymenolepis nana causing hyperinfection which was confirmed by microbiological investigation of his stool sample, sent immediately during postmortem. H. nana contributes to the majority of zoonotic helminth parasites that are considered to be the cause of "neglected diseases" by WHO. This parasite is ubiquitous in nature, usually prevalent among children residing in underprivileged countries with inadequate sanitation and personal hygiene. H. nana is the only cestode that can be transmitted directly from person to person and shows endogenous autoinfection. It can also be acquired by accidental ingestion of flour beetles and fleas, serving as intermediate hosts. Apart from the usual asymptomatic conditions causing mild infections, there is hyperinfection state (>500 eggs/g of stool) with most probable symptoms, like weight loss, abdominal pain, headache, and diarrhea with mucus seen in the present study.