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Hwang YH, Son W, Kim YW, Kang DH, Chang HH, Goo YK, Hong Y, Chung DI. A Retrieved Sparganum of Spirometra erinaceieuropaei from a Korean Man during Mechanical Thrombectomy. THE KOREAN JOURNAL OF PARASITOLOGY 2020; 58:309-313. [PMID: 32615744 PMCID: PMC7338899 DOI: 10.3347/kjp.2020.58.3.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/05/2020] [Indexed: 11/23/2022]
Abstract
Human sparganosis is a zoonotic disease caused by infection and migration of the plerocercoid of Spirometra spp. Although sparganosis were reported from most parts of the body, the sparganum parasitizing inside cerebral artery is remarkably uncommon. We report a case of cerebral intravascular sparganosis in an elderly patient with acute ischemic stroke who was diagnosed by retrieving sparganum during mechanical thrombectomy. Finally, the parasites were identified as Spirometra erinaceieuropaei using multiplex PCR and cox1 gene sequencing.
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Affiliation(s)
- Yang-Ha Hwang
- Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Wonsoo Son
- Department of Neurosurgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea.,Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Yong-Won Kim
- Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea.,Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Dong-Hun Kang
- Department of Neurosurgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea.,Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Hyun-Ha Chang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Youn-Kyoung Goo
- Department of Parasitology and Tropical Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Yeonchul Hong
- Department of Parasitology and Tropical Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Dong-Il Chung
- Department of Parasitology and Tropical Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
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Lo Presti A, Aguirre DT, De Andrés P, Daoud L, Fortes J, Muñiz J. Cerebral sparganosis: case report and review of the European cases. Acta Neurochir (Wien) 2015; 157:1339-43; discussion 1343. [PMID: 26085111 DOI: 10.1007/s00701-015-2466-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
Abstract
Sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni, also called "sparganum." In human hosts, the Spirometra mansoni larva commonly targets the subcutaneous tissue or muscle. Sometimes it can also migrate into the brain, resulting in cerebral sparganosis, mainly characterized by focal neurological symptoms such as seizures and radiological "wandering lesions" on magnetic resonance images (MRIs). Clinical cases of cerebral sparganosis have been reported worldwide, mainly in Asian countries, but also in North America, South America and Australia. Only two cases have been previously reported in Europe. A 29-year-old male from Bolivia, who lived in Spain, presented to our service for seizures and a multicystic brain lesion, initially suspected to be a dysembryoplastic neuroepithelial tumor (DNET). He underwent gross total resection of the mixed solid/cystic lesion. Pathology revealed gliosis, multiple interconnected cystic cavities with fibrous walls, inflammatory cell infiltration and no necrotizing granulomatous reaction. Inside the cavities, a parasitic form was identified as the larva of the cestode Spirometra mansoni. At 1-year follow-up, the patient had no deficits and was seizure free. Clinicians should be alerted to the possible existence of this rare entity in Europe, especially in patients from endemic areas with a possible infection history as well as "wandering lesions" on the MRI.
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Oh Y, Kim JT, Kim MK, Chang YJ, Eom K, Park JG, Lee KM, Choe KH, An JY. Eosinophilic pleuritis due to sparganum: a case report. THE KOREAN JOURNAL OF PARASITOLOGY 2014; 52:541-3. [PMID: 25352705 PMCID: PMC4210739 DOI: 10.3347/kjp.2014.52.5.541] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/03/2014] [Accepted: 07/03/2014] [Indexed: 12/03/2022]
Abstract
Sparganosis is a rare parasitic disease caused by migrating plerocercoid tapeworm larva of the genus Spirometra. Infection in humans is mainly caused by the ingestion of raw or inadequately cooked flesh of infected frogs, snakes, and chickens. Here, we report a rare case of a 45-year-old man who was admitted to our hospital with left lower chest pain. The chest radiograph and computed tomography (CT) scan revealed localized pleural effusion in the left lower lobe; further, peripheral blood eosinophilia and eosinophilic pleural effusion were present. Percutaneous catheter drainage was performed, which revealed long worm-shaped material that was identified as a sparganum by DNA sequencing. The patient showed clinical improvement after drainage of the sparganum. This study demonstrates the importance of considering parasitic diseases in the differential diagnosis of eosinophilic pleural effusion.
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Affiliation(s)
- Youngmin Oh
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Jeong-Tae Kim
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Mi-Kyeong Kim
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - You-Jin Chang
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Keeseon Eom
- Department of Parasitology, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea. ; Medical Research Institute and Parasite Resource Bank, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Jung-Gi Park
- Department of Parasitology, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea. ; Medical Research Institute and Parasite Resource Bank, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Ki-Man Lee
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Kang-Hyeon Choe
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
| | - Jin-Young An
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 361-711, Korea
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Santosh V, Mahadevan A, T. Chickabasaviah Y, Bharath RD, S. Krishna S. Infectious lesions mimicking central nervous system neoplasms. Semin Diagn Pathol 2010; 27:122-35. [DOI: 10.1053/j.semdp.2010.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Tapeworms are among the oldest afflictions of humans. They continue, even today, to be an important cause of morbidity and mortality, worldwide. Taenia saginata and Taenia solium infections are still common in many developing countries. Diphyllobothrium latum infections, are decreasing, but this tapeworm, transmitted to humans through the eating of raw salmon, can cause severe anemia. Hymenolepis and Dipylidium infections may occur to children. Hydatid disease is a common cause of morbidity, especially among immigrant groups from endemic areas of the Mediterranean; the liver is the most common site of a hydatid cyst. Although surgery has been the mainstay of therapy, drug therapy and percutaneous aspiration have been used more frequently in recent years. praziquantel and albendazole are the two most useful drugs against various tapeworm infections.
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Affiliation(s)
- Herbert B. Tanowitz
- Departments of Pathology and Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
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Goh KY, Poon WS. Recombinant tissue plasminogen activator for the treatment of spontaneous adult intraventricular hemorrhage. SURGICAL NEUROLOGY 1998; 50:526-31; discussion 531-2. [PMID: 9870812 DOI: 10.1016/s0090-3019(97)00504-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Intraventricular hemorrhage (IVH) has a poor prognosis with mortality rates of between 80 and 100% when all four ventricles are involved. Fibrinolytic therapy has been reported to improve overall outcome. METHODS Patients with severe primary IVH were treated by direct intraventricular injection of recombinant tissue plasminogen activator (rt-PA) into the lateral ventricles, followed by cerebrospinal fluid (CSF) drainage if the intracranial pressure rose above 20 mm Hg. RESULTS Over a 15-month period from 1995 through 1996, 10 patients were treated, (4 male and 6 female, mean age 35 years; range, 21-55 years). The mean Glasgow Coma Scale score on admission was 6 (range, 4-8) and the mean Graeb score for severity of IVH on the first CT scan was 10 (range, 8-12). Angiography was negative in five cases but identified arteriovenous malformations in three, a post-traumatic pseudoaneurysm in one, and Moya-moya disease in one. The mean total dose requirement of rt-PA was 8.25 mg (range, 6-12 mg) with a significant reduction in the mean Graeb score after 7 days to 3.9 (range, 2-7, p<0.0001). Outcome at 3 months was death in one case (mortality 10%), severe disability in two (20%), moderate disability in three (30%), and good result in four (40%). Four patients (40%) required subsequent CSF shunting. No complications of rehemorrhage, infection, or catheter obstruction were encountered. CONCLUSION Intraventricular fibrinolysis with rt-PA seems to be safe and effective for the treatment of severe IVH.
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Affiliation(s)
- K Y Goh
- Neurosurgical Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT
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