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BMJ Case Reports May 2019Sparganosis is a rare zoonotic parasitosis that is sporadically reported worldwide. In Australia, the causative tapeworms are considered endemic in wildlife animals,...
Sparganosis is a rare zoonotic parasitosis that is sporadically reported worldwide. In Australia, the causative tapeworms are considered endemic in wildlife animals, however, there have been only five reported human infections. We present three additional cases of sparganosis, involving two Australian born gentlemen who have never travelled overseas and a woman who emigrated from Ethiopia. The first man presented with two unusual subcutaneous lumps that migrated along the anterior abdominal wall connected by a tunnel. The second man presented with two separate lumps, one on the thigh and the other on the left upper abdomen over a 4-week interval. The woman presented with 6 weeks of intermittent fevers, night sweats, abdominal pain and passing intestinal worms. This series of patients suggests that sparganosis is under-recognised in Australia and serves as a reminder for clinicians to the varied presentations that can be characteristic of this lesser known zoonosis.
Topics: Abdominal Pain; Abdominal Wall; Adult; Aged, 80 and over; Animals; Australia; Female; Fever; Foodborne Diseases; Humans; Male; Neglected Diseases; Sparganosis; Spirometra; Thigh; Treatment Outcome
PubMed: 31061178
DOI: 10.1136/bcr-2018-228396 -
Eye (London, England) Sep 2019Orbital sparganosis represents an extremely rare condition with only a few cases being reported in literature. Here we describe cases of orbital sparganosis, including...
PURPOSE/BACKGROUND
Orbital sparganosis represents an extremely rare condition with only a few cases being reported in literature. Here we describe cases of orbital sparganosis, including their etiology, clinical findings, and surgical outcomes.
PATIENTS AND METHODS
A retrospective review was performed on patients with orbital sparganosis, who were treated at Zhongshan Ophthalmic Center, of Sun Yat-sen University, China between 2000 and 2012.
RESULTS
Five patients (three males and two females, one right orbit and four left orbits) were identified. Their mean age was 14.8 years (range = 6-33 years). Four cases were contracted from eating raw snakes and fishes, or placing poultices of frog on open wounds. All cases showed a swelling and/or redness of the eyelid and conjunctiva, and a migrating inflammation was present in one of the cases. High levels of blood eosinophils were observed in three of these cases. Of the two patients examined using computed tomography, one showed a diffuse soft tissue infiltration and a punctate calcification, while one of the three patients examined using magnetic resonance imaging displayed an annular "tunnel sign" within the lesion. All patients underwent an anterior orbitotomy and the entire worm was removed with no surgical complications.
CONCLUSIONS
Orbital sparganosis should be highly suspected in patients with a history of eating raw snakes and frogs, a migrating orbital inflammation and the presence of eosinophilia. Orbital imaging examinations play an important role in the diagnosis of orbital sparganosis. Surgical removal of the entire worm is required.
Topics: Adolescent; Adult; Asian People; Child; China; Eye Infections, Parasitic; Female; Follow-Up Studies; Humans; Intraocular Pressure; Magnetic Resonance Imaging; Male; Ophthalmologic Surgical Procedures; Orbital Diseases; Retrospective Studies; Sparganosis; Tomography, X-Ray Computed; Visual Acuity; Young Adult
PubMed: 30944463
DOI: 10.1038/s41433-019-0427-x -
The Korean Journal of Parasitology Feb 2019
Topics: Animals; History, 20th Century; History, 21st Century; Host-Parasite Interactions; Humans; Paragonimiasis; Paragonimus; Parasitology; Republic of Korea; Sparganosis; Sparganum; Taenia solium; Taeniasis
PubMed: 30840805
DOI: 10.3347/kjp.2019.57.1.77 -
Parasitology International Jun 2019
Topics: Abdomen; Animals; Europe; Female; Humans; Middle Aged; Poland; Red Meat; Skin; Sparganosis; Spirometra; Ultrasonography; Zoonoses
PubMed: 30794872
DOI: 10.1016/j.parint.2019.02.005 -
The American Journal of Tropical... Mar 2019Praziquantel is widely used for treating parasitic infections globally, especially in countries with endemic schistosomiasis. However, severe hypersensitivity to...
Praziquantel is widely used for treating parasitic infections globally, especially in countries with endemic schistosomiasis. However, severe hypersensitivity to praziquantel has rarely been reported. We report the case of a 30-year-old Japanese man who developed acute generalized exanthematous pustulosis (AGEP), which is a rare and severe cutaneous reaction usually triggered by drugs, after taking praziquantel. During medical examination, eggs of were found in his stool. He took praziquantel 600 mg for 1 day and developed skin rashes and fever the next day. Pruritic generalized maculopapular erythematous eruptions were observed over the entire body. He had elevated white blood cell count, liver enzymes, and C-reactive protein level. We prescribed acetaminophen, fexofenadine hydrochloride, loxoprofen sodium, and topical ointments including difluprednate and hydrocortisone. Over the next 3 days, he developed pinhead-sized, non-follicular pustules on his diffusely erythematous skin. Histological findings of the pustular lesion showed spongiform subcorneal pustules with perivascular inflammatory cells. Approximately 8 days after taking praziquantel, the pustules resolved with desquamation. He became afebrile on day 9 and his laboratory parameters returned to normal levels on day 16. He was diagnosed with AGEP caused by praziquantel. Physicians need to be aware that praziquantel could cause AGEP, although it is generally considered a safe drug.
Topics: Acute Generalized Exanthematous Pustulosis; Adult; Animals; Anthelmintics; Anti-Inflammatory Agents; Diphyllobothriasis; Diphyllobothrium; Feces; Humans; Male; Praziquantel
PubMed: 30675838
DOI: 10.4269/ajtmh.18-0832 -
Journal of Radiology Case Reports Aug 2018The tunnel sign has been described as a specific feature of cerebral sparganosis. We present a case of a 55-year-old gentleman found to have cerebral melioidosis and...
The tunnel sign has been described as a specific feature of cerebral sparganosis. We present a case of a 55-year-old gentleman found to have cerebral melioidosis and with initial imaging mimicking the appearance of sparganosis. This suggests that the tunnel sign in brain abscesses may be specific for infection by Burkholderia Pseudomallei, Spirometra Mansoni or Listeria Monocytogenes.
Topics: Anti-Bacterial Agents; Brain Abscess; Contrast Media; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Melioidosis; Middle Aged; Sparganosis; Tomography, X-Ray Computed
PubMed: 30651915
DOI: 10.3941/jrcr.v12i8.3441 -
PLoS Neglected Tropical Diseases Jan 2019Cerebral sparganosis is the most serious complication of human sparganosis. Currently, there is no standard for the treatment of inoperable patients. Conventional-dose...
BACKGROUND
Cerebral sparganosis is the most serious complication of human sparganosis. Currently, there is no standard for the treatment of inoperable patients. Conventional-dose praziquantel therapy is the most reported treatment. However, the therapeutic outcomes are not very effective. High-dose praziquantel therapy is a useful therapeutic choice for many parasitic diseases that is well tolerated by patients, but it has not been sufficiently evaluated for cerebral sparganosis. This study aims to observe the prognoses following high-dose praziquantel therapy in inoperable patients and the roles of MRI and peripheral eosinophil absolute counts during follow-up.
METHODOLOGY
Baseline and follow-up epidemiological, clinical, radiological and therapeutic data related to 10 inoperable patients with cerebral sparganosis that were treated with repeated courses of high-dose praziquantel therapy, with each course consisting of 25 mg/kg thrice daily for 10 days were assessed, followed by analyses of the prognoses, MRI findings and peripheral eosinophil absolute counts.
PRINCIPAL FINDINGS
Baseline clinical data: the clinical symptoms recorded included seizures, hemiparesis, headache, vomiting and altered mental status. Peripheral blood eosinophilia was found in 3 patients. The baseline radiological findings were as follows. Motile lesions were observed in 10 patients, including aggregated ring-like enhancements, tunnel signs, serpiginous and irregular enhancements. Nine of the 10 patients had varying degrees of white matter degeneration, cortical atrophy and ipsilateral ventricle dilation. The follow-up clinical data were as follows. Clinical symptom relief was found in 8 patients, symptoms were eliminated in 1 patient, and symptoms showed no change from baseline in 1 patient. Peripheral blood eosinophilia was found in 2 patients. The follow-up radiological findings were as follows. Motile lesions that were transformed into stable, chronic lesions were found in 8 patients, and motile lesions that were eliminated completely were found in 2 patients.
CONCLUSIONS
High-dose praziquantel therapy for cerebral sparganosis is effective. The radiological outcomes of motile lesions are an important indicator during the treatment process, especially during follow-ups after clinical symptoms have improved. Peripheral eosinophil absolute counts cannot be used as an effective prognostic indicator.
Topics: Adolescent; Adult; Animals; Anthelmintics; Antibodies, Helminth; Child; Epilepsy; Female; Follow-Up Studies; Foodborne Diseases; Humans; Male; Middle Aged; Oxcarbazepine; Praziquantel; Retrospective Studies; Sparganosis; Sparganum; Treatment Outcome; Young Adult
PubMed: 30640909
DOI: 10.1371/journal.pntd.0007018 -
Journal of Korean Medical Science Oct 2018Sparganosis is a larval cestodiasis caused by the plerocercoid of spp. Since the first description of human sparganosis in 1924, several hundred cases have been... (Review)
Review
BACKGROUND
Sparganosis is a larval cestodiasis caused by the plerocercoid of spp. Since the first description of human sparganosis in 1924, several hundred cases have been reported in Korea. However, systematic approaches for literature surveys of Korean sparganosis have seldom appeared.
METHODS
We searched publicly available databases such as PubMed, Research Information Sharing Service, and Korea Medical Citation Index with relevant Medical Subject Headings.
RESULTS
At least 438 Korean sparganosis cases have been described from 1924 to 2015. Preoperative diagnosis has been significantly increased since the 1980s due to popularization of serological and imaging diagnostics. Cases were largely detected from fifth decades in general, but cerebral sparganosis was detected in relatively young age groups (third and fourth decades). Sparganosis was prevalent in men (75.9%). Consumption of frog/snake and drinking unfiltered water were found in 63.4% and 16.9% of patients, respectively. Most frequently affected sites were subcutaneous tissues (49.9%), followed by the central nervous system (36.2%). Involvements of visceral organs (7.6%), ocular regions (3.6%), and muscles (2.7%) were noticed. In women, breast sparganosis constituted a large proportion (34.2%). Sparganosis associated with immunocompromised patients has recently been reported.
CONCLUSION
Sparganosis has been continuously reported in Korea during the past 90 years, although its incidence has decreased during the last 20 years. The disease is mostly characterized by subcutaneous nodule, but infection of the worm in vital organs often results in serious illness. Continuous awareness is warranted to monitor sparganosis occurrence and associated clinical consequences.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Child; Child, Preschool; Female; Humans; Incidence; Male; Middle Aged; Preoperative Period; Prevalence; Republic of Korea; Sparganosis; Spirometra; Water; Young Adult
PubMed: 30369856
DOI: 10.3346/jkms.2018.33.e273 -
PLoS Neglected Tropical Diseases Oct 2018Sparganosis is a parasitic infection caused by the plerocercoid larvae of Spirometra mansoni in East and Southeast Asia. The plerocercoid larvae sometimes invade the... (Comparative Study)
Comparative Study
BACKGROUND
Sparganosis is a parasitic infection caused by the plerocercoid larvae of Spirometra mansoni in East and Southeast Asia. The plerocercoid larvae sometimes invade the encephalon, resulting in severe cerebral sparganosis. Surgical removal of the larvae is considered a standard therapy for cerebral sparganosis. In contrast, the efficacy and safety of long-term, high-dose praziquantel treatment for cerebral sparganosis have not been explored.
METHODOLOGY/PRINCIPAL FINDINGS
In this multicenter retrospective study, we assessed the records of 96 patients with cerebral sparganosis who consulted at three medical centers from 2013 to 2017. Forty-two patients underwent surgical lesion removal, and the other 54 patients received long-term, high-dose praziquantel (50 mg/kg/day for 10 days, repeated at monthly intervals). The primary outcome was the complete disappearance of active lesions on cerebral magnetic resonance imaging. The secondary outcomes included the modified Rankin scale score at 90 days, incidence of seizure, eosinophil count, and serological Spirometra. mansoni antibody titer. The efficacy of praziquantel treatment was similar to that of surgical lesion removal for cerebral sparganosis with respect to both the primary outcome and secondary outcomes. Although binary logistic regression models also supported the primary outcome after adjustment for age, sex, lesion location, and loss to follow-up, some unavoidable confounders might have biased the statistical power. No significant clinical complications or laboratory side effects occurred in the praziquantel group with the exception of a relatively benign allergic reaction.
CONCLUSIONS/SIGNIFICANCE
In this small-sample, nonrandomized, retrospective exploratory study, some patients with cerebral sparganosis were responsive to long-term, high-dose praziquantel with an efficacy similar to that of surgical lesion removal. These findings increase the treatment flexibility for this serious infection.
Topics: Adolescent; Adult; Anthelmintics; Asia, Southeastern; Central Nervous System Parasitic Infections; Child; Female; Humans; Male; Middle Aged; Neurosurgical Procedures; Praziquantel; Retrospective Studies; Sparganosis; Treatment Outcome; Young Adult
PubMed: 30346956
DOI: 10.1371/journal.pntd.0006918 -
The American Journal of Case Reports Sep 2018BACKGROUND Spinal sparganosis and racemose (grape-like) neurocysticercosis are rare diseases. Co-infection with spinal sparganosis and racemose neurocysticercosis has...
BACKGROUND Spinal sparganosis and racemose (grape-like) neurocysticercosis are rare diseases. Co-infection with spinal sparganosis and racemose neurocysticercosis has never been reported in the English-language literature. CASE REPORT A 41-year-old male presented after having experienced left hip pain with radiation to the leg, progressive weakness and numbness of the left leg, and difficulty urinating for 4 years, all of which was caused by spinal sparganosis. He had also experienced progressive vision and hearing loss on the right side for 3 years, which were caused by racemose neurocysticercosis. Magnetic resonance imaging (MRI) of the lumbosacral spine and the brain revealed intrinsic spinal cord lesion and racemose neurocysticercosis, respectively. Spinal sparganosis was diagnosed by histological examination and an immunochromatographic test. It was treated with a high-dose of praziquantel (75 mg/kg/day) combined with cimetidine; without clinical improvement. Treatment consisted of racemose neurocysticercosis with albendazole for 2 months. A follow-up MRI of the brain revealed a minimal reduction in the amount of racemose neurocysticercosis. Repeat treatment with albendazole was administered. However, further MRI examination of the brain revealed the condition to be unchanged. Vision and hearing loss had also not improved. CONCLUSIONS In this case report, we describe a middle-aged man who presented with spinal cord symptoms (hip pain, progressive weakness and numbness of the leg, and difficulty urinating) and cranial nerve palsies (vision and hearing loss) caused by spinal sparganosis and racemose neurocysticercosis, respectively. Neurological symptoms did not improve with anthelmintic drugs.
Topics: Adult; Central Nervous System Helminthiasis; Coinfection; Humans; Magnetic Resonance Imaging; Male; Neurocysticercosis; Sparganosis; Thailand
PubMed: 30213923
DOI: 10.12659/AJCR.910729