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PubMed2001

A rare case of eosinophilic pleuritis due to sparganosis.

A rare form of sparganosis with eosinophilic pleural effusion is reported. A 62-year-old man was admitted to our hospital with left pleural effusion, and diagnosed immunologically as having sparganosis. Eosinophilia was seen in both peripheral blood and pleural effusion. The level of interleukin (IL)-5 was elevated in the pleural effusion, but not in peripheral blood. The patient was treated successfully with three consecutive doses of praziquantel (75 mg/ kg/day). After the treatment, the antibody titer in serum decreased and the eosinophil number in the peripheral blood returned to the normal level. Thus, sparganosis should be included in the differential diagnosis for eosinophilic pleuritis. The immunoserological screening test using multiple-dot ELISA is helpful to identify the causative pathogen.

Animals↗
PubMed1984

Intracranial sparganosis: an uncommon infection. Case report.

The first case of intracranial sparganosis to be reported from the United States is presented. The patient, a 27-year-old woman, complained of focal seizures involving the right lower extremity. A left parietal parasagittal craniotomy was performed, and a granuloma containing a sparganum was excised from the parietal lobe. The clinical and pathological features of sparganosis are reviewed. Only five cases of intracranial sparganosis have previously been described.

Adult↗
PubMed1996

Cerebral sparganosis: clinical manifestations, treatment, and outcome.

Cerebral sparganosis is a rare parasitic disease caused by infestation by the plerocercoid larva of Spirometra mansoni. The authors retrospectively analyzed 17 cases of cerebral sparganosis treated at Seoul National University Hospital between 1986 and 1994. The patients' ages at diagnosis ranged from 6 to 57 years (median 32 years) and the male/female ratio was 13:4. Diagnosis was based on radiological findings, serological test results, operative findings, and histopathological examinations. Characteristic magnetic resonance (MR) findings consisted of widespread white matter degeneration and cortical atrophy, mixed-signal lesion (low in the central and high in the peripheral regions on T2-weighted images) with irregular dense enhancement of central foci and changes in the location and shape of the enhancing lesion in follow-up studies. Ten patients underwent surgical removal of the parasitic lesion, six received medical treatment alone (five with praziquantel and one with antiepileptic drugs), and one underwent insertion of a ventriculoperitoneal shunt and a course of praziquantel. Follow-up periods ranged from 13 to 111 months (mean 49 months). Seven patients who underwent complete removal of the lesion, live worm, or degenerative worm with surrounding granuloma showed a favorable course. Patients who received medical treatment alone or incomplete removal exhibited progression in their neurological deficits and their seizures could not be controlled. Medication with praziquantel seemed to have no killing effect on live worms. The authors conclude that MR imaging is the most valuable modality for the early detection of cerebral sparganosis and that complete surgical removal of granuloma together with worms, whether they are alive or degenerative, is the treatment of choice.

Adolescent↗
PubMed2001

A case of intramuscular sparganosis in the sartorius muscle.

Intramuscular sparganosis is not common, and its rarity makes it difficult to be distinguished from soft tissue tumors. A case of rare intramuscular sparganosis is reported. A 44-year-old man presented with a painful mass in the left thigh for 8 months, which was initially diagnosed a as soft tissue tumor. Ultrasonography and MRI revealed a multilobulated mass in the sartorius muscle. After the needle biopsy under the guidance of ultrasonography, sparganum was discovered under microscopic examination of the excised tissue. Surgical excision was performed, and a live larva of sparganum was removed. Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among Koreans who have frequently ingested mountain water and consumed raw snakes or frogs.

Adult↗
PubMed1994

Serodiagnosis of human sparganosis by a monoclonal antibody-based competition ELISA.

Competition ELISA test using sparganum specific monoclonal antibodies (Mab) was investigated to improve the diagnostic specificity of sparganosis. By cell fusion, one hybridoma clone secreting anti-sparganum specific Mab was selected (Sp-20), which reacted on bands of 32 kDa and 38 kDa. Sp-20 reacted on calcium corpuscles on IFA. By micro-ELISA, 16 of 17 sparganosis cases (95%) were found positive, but 1 of 18 clonorchiasis cases (5%), 4 of 16 cysticercosis cases (25%) and 2 of 16 normal controls (11%) showed false positive reactions. On the other hand, by competition ELISA using a sparganum specific Mab (Sp-20), 16 out of 17 (95%) of sparganosis cases were found positive, but 2 of 18 clonorchiasis cases (10%), 2 of 16 cysticercosis cases (12%), 3 of 16 paragonimiasis cases (18%) and 1 of 16 normal controls (6%) showed false positive reactions.

Animals↗
PubMed1994

Cerebral sparganosis in an East Timorese refugee.

OBJECTIVE: To report the first case of cerebral sparganosis diagnosed in Australia. CLINICAL FEATURES: A 23-year-old East Timorese refugee, whose diet before migration included raw snakes and frogs, presented with a generalised tonic-clonic seizure and a nine-month history of episodic left hemianaesthesia. Computerised axial tomography of the brain showed a right frontal lesion, which was excised, and histological examination demonstrated changes typical of sparganosis. INTERVENTION AND OUTCOME: Excision of the lesion resulted in cure. Postoperative eosinophilia and a subcutaneous nodule presumed to be due to disseminated sparganosis resolved following a course of praziquantel. CONCLUSION: Clinicians should consider the possibility of unusual parasitic infections in refugees who present with intracranial space-occupying lesions, especially those from developing countries. A dietary history may aid the diagnosis.

Adult↗
PubMed2001

Pulmonary sparganosis: a case report with five years follow-up.

Sparganosis has a world wide distribution, but only a few patients have pulmonary involvement. The term sparganosis is defined as an infection by the larva of parasitic tapeworms of Spirometra species. We present here-in a patient, who was infected by this parasite and had pulmonary symptoms. The chest roentgenography revealed diffuse multiple nodular infiltration with cavitations. Bronchoscopy with a transbronchial lung biopsy was nondiagnostic. Finally, open lung biopsy was performed, and the histologic examination revealed plerocercoid larva of sparganum. The patient was treated with mebendazole 40 mg/kg/day for 6 months and his symptoms and pulmonary function improved. In the 5th year of follow-up, he presented with more progressive dyspnea and developed cor pulmonale, and finally died from pneumonia with sepsis. The objective of this report was to present a rare manifestation of sparganosis and it's clinical course. Currently, there is no known effective treatment for this disease.

Adult↗
PubMed1996

[A case of Sparganosis mansoni with a painless mass in the inguinal region and the scrotum].

Sparganosis mansoni rarely occurs in the inguinal and perineal regions in Japan. A case of Sparganosis mansoni with a painless mass in the left inguinal region is presented. A 67-year-old male visited our hospital with a complaint of a painless mass in the left inguinal region in May, 1995, and another mass appeared in the scrotum two days after the first visit. Ultrasonography revealed a solid subcutaneous mass 2 cm in diameter. These masses were surgically excised by an inguinal approach and a parasite, 10 cm in length, was found in the mass. The parasite was diagnosed histologically as Sparganosis mansoni, which is a larva of the genus Diphyllobothrium.

Aged↗
PubMed1997

Cerebral sparganosis: increased uptake of technetium-99m-HMPAO.

Cerebral sparganosis is an extremely rare intracranial parasitic infectious disease. We report findings of 99mTc-HMPAO cerebral perfusion SPECT in a case with cerebral sparganosis. SPECT revealed an irregularly shaped area with markedly increased 99mTc-HMPAO uptake in the parasitic infectious region of the cerebrum. Both white and gray matter was involved, the white matter involved predominantly. Decreased perfusion to the right cerebellum, suggesting cross cerebellar diaschisis, was also demonstrated. This article illustrates that cerebral sparganosis is one of the causes of increased 99mTc-HMPAO uptake in the cerebrum and should be considered clinically if present.

Aged↗
PubMed1964

[A Case Report Of Sparganosis]

A case of sparganosis was presented. The patient was a 43-year-old Korean male who had a history of having eaten raw flesh of snake and frog in Keoje Island during 1950 to 1952 for the purpose of treatment of arthritis by the oriental custom. In the summer, l959, he had slight itching sensation in the left lower scrotal area. A few months later, he noticed the appearance of a peanut-sized mass in that area. However, the mass enlarged gradually to a hen's egg size during two years. On surgical exploration, the mass was found to be a fibro-connective tissue capsule(3 to 4 cm in diameter) in the lower left scrotal area. From the capsule three larvae(l9 to 28 cm by 2 to 6 mm) were freed by dissection without much difficulty. The sources of infection of some formerly reported sparganosis in Korea were discussed. It is most probable that human sparganosis is acquired by ingestion of raw flesh of snake and frog in this country.

Journal Article↗
PubMed1980

Histopathologic Study On Human Sparganosis.

Based on 16 cases of human sparganosis, a histopathological study was made. There was a striking similarity among histological features of sparganosis involving different tissues. The histological change of the affected tissues was characterized by a necrotizing and granulomatous inflammation with or without worm parasite in the lesions. There was also a remarkable polymorphonuclear leukocytic mobilization, predominantly of eosinophils, plasma cells and lymphocytes in and near the lesions. Tunnel formation lined by palisading histiocytes was another charateristic feature of the host tissue reaction. These findings were quite distinguishable from those of cysticercosis which were more localized and self-limited. Several features that were prominent in section slides of sparganum worm parasite were also noted. Laminated calcospherules found in the cytoplasm of the proliferating macrophages and giant cells were of diagnostic value of sparganosis in the absence of the worm, particularly when these were accompanied with tunnel-like lesion in the host tissue.

Journal Article↗
PubMed1992

Cerebral sparganosis: analysis of 34 cases with emphasis on CT features.

Cerebral sparganosis is a rare parasitic CNS disease, producing chronic active granulomatous inflammation. We retrospectively reviewed the clinical data, CT scans and histopathologic specimens in 34 patients with cerebral sparganosis. The majority of the patients (89%) were rural inhabitants; 75% had a history of ingestion of frogs and/or snakes. The major presenting symptoms were seizure (84%), hemiparesis (59%) and headache (56%) of chronic course. On CT scans, the disease most frequently involved the cerebral hemispheres, particularly frontoparietal lobes, with occasional extension to the external and internal capsules and basal ganglia. The cerebellum was rarely involved. Bilateral involvement was seen in 26%. The main CT findings consisted of white matter hypodensity with adjacent ventricular dilatation (88%), irregular or nodular enhancing lesion (88%), and small punctate calcifications (76%). In combination, the CT triad above appears to be specific for this disease, and was noted in 62% of cases. Of 16 follow-up CT scans, 5 (38%) showed a change in the location of the enhancing nodule. With a single CT scan, it does not appear to be possible to determine whether the worm is alive or dead, information important for deciding whether to intervene surgically. Change in the location of the enhancing nodule and/or worsening of the other CT findings on sequential CT scans would suggest that the worm is alive and that the patient is a candidate for surgery.

Adult↗
PubMed1992

Sparganosis in the spinal canal with partial block: an uncommon infection.

A case of rare intraspinal sparganosis treated by surgical excision is described. In this 59-year-old male with paraparesis and voiding problem, an intradural mass was noted on myelogram. Magnetic resonance (MR) and computed tomographic appearance of spinal and associated cerebral lesion are illustrated and possible route of migration discussed. This represents, to our knowledge, the first MRI demonstration of intraspinal sparganosis reported in the literature.

Humans↗
PubMed1990

Cerebral sparganosis mansoni. Report of two cases.

Among diseases due to cerebral parasitism, that caused by Sparganum mansoni, the larva of Spirometra mansoni, is very rare. We have encountered two such cases. A computed tomography scan in both revealed a nodular high density contrast enhanced area against an extensive low density background area. Neither calcification nor cyst formation was recognized. These computed tomography scan findings were thought to be characteristic for cerebral sparganosis mansoni and were difficult to differentiate from those of a cerebral tumor. In both cases, definitive diagnosis was achieved by identification of the worm after excision of the lesion. The best treatment for cerebral sparganosis mansoni is surgical excision of the lesion, and in the two cases presented the postoperative outcome was good.

Animals↗
PubMed2004

Eyelid sparganosis.

PURPOSE: To report a case of sparganosis in the muscle layer of the eyelid. DESIGN: Observational case report. METHODS: A 67-year-old man with migratory painful swelling on the eyelid that was unresponsive to medications was evaluated and treated surgically. RESULTS: Computed tomography showed a 1.5 x 1.5-cm sized, thick-walled lesion and ultrasound biomicroscopy showed hypoechoic tubular and cystic lesions. During surgery, a white, thread-like plerocercoid, 7 cm in length was detected in the orbicularis muscle of the lower eyelid. Histopathologic examination demonstrated the characteristic feature of the sparganum larva and foreign body granulomatous reaction. Serodiagnosis by enzyme-linked immunosorbent assay was positive. Three months postoperatively, the lesion resolved completely. CONCLUSION: Although rare, sparganosis should be suspected in a moving eyelid mass unresponsive to the medical treatment.

Aged↗
PubMed2004

Fournier's gangrene associated with sparganosis in the scrotum.

Fournier's gangrene is a necrotizing fasciitis of the scrotum or perineum that may extend by way of the fascial planes to the penis and the anterior abdominal wall up to the clavicles, buttocks, or lower extremities. It is a life-threatening progressive disease that requires aggressive antibiotic therapy and early radical debridement. Sparganosis is a parasitic infection that occurs principally in cats and dogs, but human infestations have been reported, albeit rarely. Recently, we experienced a case of Fournier's gangrene associated with sparganosis in the scrotum, which was treated with antibiotics and extensive debridement including removal of a white, flat, shiny sparganum worm.

Alcoholism↗
PubMed1986

Human sparganosis.

A case of human sparganosis is reported. Approximately sixty-eight such cases have been reported from the United States, most having been found in the southern states. Clinically sparganosis appears as a subcutaneous nodule. Diagnosis is established after the larval worm has been identified in the excised tissue. Excision of the lesion is curative.

Abdominal Muscles↗
PubMed2002

Sparganosis: a rare case of the oral cavity.

Sparganosis is a rare parasitic disease. We here reported an extremely rare case of intraoral sparganosis in a 21-year-old Thai female. Clinically, the lesion presented as an asymptomatic nodule 1 cm x 1 cm in the left upper labial mucosa. An excisional biopsy was performed and the pathological examinations revealed a larva of a sparganum surrounded by a fibrous capsule heavily infiltrated with eosinophils. Excision of the lesion was curative. The possible route of infection of the patient might be due to drinking water, contaminated with Cyclops containing procercoid larvae.

Adult↗