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Dirgahayu P, Ilyas MF, Rahma AA, Hanifa SN, Wijayanto MA, Triniputri WY, Lukas GA, Wiyono N, Sari Y, Mashuri YA. Recent update on cerebral sparganosis: A bibliometric analysis and scientific mapping. NARRA J 2024; 4:e982. [PMID: 39280299 PMCID: PMC11394178 DOI: 10.52225/narra.v4i2.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/13/2024] [Indexed: 09/18/2024]
Abstract
Human sparganosis, a parasitic infection prevalent in Asia, can progress to cerebral sparganosis, a severe condition with significant neurological symptoms. Diagnosis and treatment are challenging due to its clinical similarity to other infections, highlighting the need for improved detection and management strategies. The aim of this study was to observe research trends, key contributors, gaps in the existing knowledge, diagnosis challenges, effective treatment options, and prevention strategies, providing recommendations for future research directions and clinical practice improvements on cerebral sparganosis. A bibliometric analysis was conducted by extracting 139 documents from the Scopus database in June 2024. The retrieved data were analyzed using the R package's Bibliometrix (Biblioshiny) and VOSviewer. Spanning 97 different sources, the research exhibited an annual growth rate of 2.5%. Annual scientific production revealed fluctuating research activity with peaks in 2010 and 2011 and notable citation peaks in 1996 and 2005, indicating pivotal studies that significantly influenced subsequent research. Early studies focused on diagnosis and specific parasites, while recent studies (2010-2024) have increasingly addressed clinical outcomes, treatment strategies, and advanced diagnostic techniques. Trends revealed a shift towards clinical and diagnostic advancements, with recent emphasis on diagnostic imaging, immunoassays, and the relationship between cerebral sparganosis and brain tumors. In conclusion, the studies on cerebral sparganosis underscore the potential for enhancing clinical practice by improving diagnostic accuracy, informing treatment decisions, and implementing targeted screening efforts based on epidemiology and risk factors. Recommendation to further study needs to notify the cerebral sparganosis in high-risk countries with similar socioeconomic and cultural characteristics to endemic regions, including Indonesia.
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Affiliation(s)
- Paramasari Dirgahayu
- Department of Parasitology and Mycology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Muhana F. Ilyas
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Annisa A. Rahma
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Shafira N. Hanifa
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Matthew A. Wijayanto
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Winastari Y. Triniputri
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Graciella A. Lukas
- Medical Profession Program, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Nanang Wiyono
- Department of Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Yulia Sari
- Department of Parasitology and Mycology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Yusuf A. Mashuri
- Department of Parasitology and Mycology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Chen X, Wu H, Lu L, Zhou N, Chen Z, Zhang X. Cerebral sparganosis in a child with corpus callosum invasion: a case report. BMC Infect Dis 2023; 23:350. [PMID: 37231358 DOI: 10.1186/s12879-023-08322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Invasion of the corpus callosum by sparganosis is rare in children. After invading the corpus callosum, sparganosis has various migration modes, which can break through the ependyma and enter the ventricles, thus causing secondary migratory brain injury. CASE PRESENTATION A girl aged 4 years and 7 months presented with left lower limb paralysis for more than 50 days. Blood examination showed that the proportion and absolute number of eosinophils in the peripheral blood were increased. Furthermore, enzyme-linked immunosorbent assay of serum and cerebrospinal fluid samples revealed positivity for IgG and IgM antibodies for sparganosis. Initial magnetic resonance imaging (MRI) revealed ring-like enhancements in the right frontoparietal cortex, subcortical white matter, and splenium of the corpus callosum. Within 2 months, a fourth follow-up MRI showed that the lesion had spread to the left parietal cortex, subcortical white matter, and deep white matter in the right occipital lobe and right ventricular choroid plexus, with left parietal leptomeningeal enhancement. CONCLUSION Migratory movement is one of the characteristics of cerebral sparganosis. When sparganosis invades the corpus callosum, clinicians should be aware that it may then break through the ependyma and enter the lateral ventricles, leading to secondary migratory brain injury. Short-term follow-up MRI is necessary to evaluate the migration mode of sparganosis and dynamically guide treatment strategies.
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Affiliation(s)
- Xiwen Chen
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Huiying Wu
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Lianwei Lu
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Ning Zhou
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Zhen Chen
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Xiaochun Zhang
- Department of Radiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China.
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Xiang H, Wang J, Tan D, Xiong Y, Huang P, Shen Y, Xu Y, Gong Z, Hu F, Xu C, Wu J, Liu W, Liu J, Wan H, Hong D, Xie H. The serum IgG antibody level as a biomarker for clinical outcome in patients with cerebral sparganosis after treatment. Front Immunol 2023; 14:1158635. [PMID: 37051247 PMCID: PMC10083495 DOI: 10.3389/fimmu.2023.1158635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionCerebral sparganosis is a rare parasitic infection of the brain tissue. The remission of MRI change and clinical symptom has been used to evaluate the therapeutic effect. However, there is no study to correlate the serum IgG antibody level of sparganum to the prognosis of disease after treatment. Methods87 patients with cerebral sparganosis were collected from three medical centers. Clinical symptoms and MRI changes were evaluated at 12 months after initial treatment, and serum IgG antibody level of sparganum was evaluated at 2, 6, and 12 months after treatment. The positive cut-off value was based on 2.1 times the optical density (OD) of negative control. The index value was defined as the sample OD divided by the cut-off value.ResultsAmong the 87 patients after treatment, 71 patients had good clinical outcomes, and 16 had poor clinical outcomes. The area under the curve (AUC) showed that the index value measured at 12 months after treatment had the best prediction effect, with a value of 2.014. In the good-outcome group, the index values were less than 2.014 in all 71 patients, and only 8 patients had mildly enhanced residual lesions on MRI. In the poor-outcome group, the index values were more than 2.014 in all 16 patients, and all patients still showed significantly enhanced lesions on MRI. Compared with poor-outcome patients, only 2 patients with good outcomes had disease recurrence after treatment.DiscussionThis study provided evidence that the serum IgG antibody level of sparganum was a promising biomarker to evaluate the prognosis of patients with cerebral sparganosis after treatment.
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Affiliation(s)
- Haijie Xiang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jie Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dandan Tan
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ying Xiong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pengcheng Huang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Shen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yun Xu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Zhihong Gong
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Fei Hu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Chunhua Xu
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jie Wu
- Department of Neurosurgery, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Wei Liu
- Department of Outpatient, The Nanchang City First Hospital, Nanchang, China
| | - Junpu Liu
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
| | - Hui Wan
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Daojun Hong, ; Huiqun Xie,
| | - Huiqun Xie
- Clinical Department, Jiangxi Provincial Institute of Parasitic Disease, Nanchang, China
- *Correspondence: Daojun Hong, ; Huiqun Xie,
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Diagnosis and management of cerebral sparganosis: An uncommon parasitic infection of the brain. Radiol Case Rep 2022; 17:1874-1880. [PMID: 35401890 PMCID: PMC8990059 DOI: 10.1016/j.radcr.2022.02.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 11/20/2022] Open
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Hu J, Liao K, Feng X, Jiang D, Liu H, Zheng Q, Qiu H, Hua F, Xu G, Xu C. Surgical treatment of a patient with live intracranial sparganosis for 17 years. BMC Infect Dis 2022; 22:353. [PMID: 35397512 PMCID: PMC8994396 DOI: 10.1186/s12879-022-07293-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background The incidence of sparganosis, especially intracranial live sparganosis is very low in China. Due to the lack of typical clinical manifestations, it is difficult to make a clear preoperative diagnosis of the disease, which often leads to delays the disease and serious consequences. Case presentation A 23-year-old man presented with a 17-year history of intermittent seizures and right extremity numbness and weakness. Magnetic resonance imaging (MRI) showed patchy, nodular and line-like enhancement. Enzyme-linked immunosorbent assay (ELISA) detected positive antibodies to Spirometra mansoni in peripheral blood and cerebrospinal fluid (CSF). In addition, during the operation, an ivory-colored live sparganosis was removed under the precise positioning of neuronavigation, and the patient was diagnosed with cerebral sparganosis. The patient began praziquantel and sodium valproate treatment after the operation, and was followed up for 3 months. There was no recurrence of epilepsy, and the weakness and numbness of the right limb improved. Conclusion Nonspecific clinical manifestations often make the diagnosis of cerebral sparganosis difficult, and a comprehensive diagnosis should be made based on epidemiological history, clinical manifestations, ELISA results and imaging findings. Surgery is the preferred method for the treatment of cerebral sparganosis, and more satisfactory results can be achieved under the precise positioning of neuronavigation. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07293-7.
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Chen Y, Chen X, Kang H. Case Report: Moving Tumor-Like Foci Behind Refractory Epilepsy-Cerebral Sparganosis Successfully Treated by Surgery After Failure of Praziquantel Treatment. Front Neurol 2022; 13:838849. [PMID: 35222259 PMCID: PMC8866191 DOI: 10.3389/fneur.2022.838849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/17/2022] [Indexed: 11/24/2022] Open
Abstract
Cerebral sparganosis is clinically non-specific and easily misdiagnosed, exposing patients to the risk of severe brain damage and neurological dysfunction caused by actively migrating larvae. Diagnostic biomarkers from typical cases can help to establish an early diagnosis and proper treatment. We present a 25-year-old woman who suffered from 9 years of refractory epilepsy and was misdiagnosed with glioma and subjected to surgery. The postoperative pathology confirmed granuloma, and the tumor-like foci reappeared 3 months later. Along with the “tunnel sign” on MRI, cerebral sparganosis was suspected and confirmed by positive serum and cerebrospinal fluid antibodies against Spirometra mansoni. The patient visited us after a failure of four cycles of praziquantel treatment, recurrent seizures and hemiplegia with basal ganglia foci. Craniotomy was not carried out until the larva moved to the superficial lobe on follow-up MRIs, and pathology revealed sparganosis granuloma. The patient became seizure-free and recovered myodynamia but had long-lasting cognitive dysfunction due to severe brain damage. This case indicated the importance of tunnel signs and moving tumor-like foci on MRI as diagnostic clues of cerebral sparganosis. An early diagnosis is vitally important to avoid severe neural dysfunction by the long-living and moving larvae. Surgical removal of the larva is a critical remedy for cases failed by praziquantel treatment.
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Affiliation(s)
- Yusi Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huicong Kang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Huicong Kang
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Liu C, Chen Z, Shaban UT, Wang M, Zhou G, Wang N, Liu Y. Misdiagnosis of cerebral sparganosis co- existing with HIV/AIDS: a case report. Int J Infect Dis 2022; 117:264-266. [PMID: 35151855 DOI: 10.1016/j.ijid.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022] Open
Abstract
Sparganosis, especially cerebral sparganosis is a rare co-morbidity of HIV/AIDS. Due to nonspecific symptoms of sparganosis, diagnosis and treatment are challenging with a very high rate of misdiagnosis. This paper summarizes the clinical data of the case cerebral sparganosis in an HIV/AIDS patient. It provides a reference for the treatment of HIV/AIDS coexisting with parasitic encephalopathy (cerebral sparganosis). Cerebral sparganosis has been reported worldwide, especially in Asian countries. To our knowledge, this is the first case report of cerebral sparganosis associated with HIV/AIDS.
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Affiliation(s)
- Chun Liu
- Changsha, Hunan, People's Republic of China.the first hospital of changsha
| | - Zhong Chen
- Changsha, Hunan, People's Republic of China.the first hospital of changsha.
| | - Ummulbanin T Shaban
- Changsha, Hunan, People's Republic of China.central south university, xiangya school of public health
| | - Min Wang
- Changsha, Hunan, People's Republic of China.the first hospital of changsha
| | - Guoqiang Zhou
- Changsha, Hunan, People's Republic of China.the first hospital of changsha
| | - Ning Wang
- Changsha, Hunan, People's Republic of China.the first hospital of changsha
| | - Yan Liu
- Changsha, Hunan, People's Republic of China.the first hospital of changsha
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Lu Y, Sun JH, Lu LL, Chen JX, Song P, Ai L, Cai YC, Li LH, Chen SH. Proteomic and Immunological Identification of Diagnostic Antigens from Spirometra erinaceieuropaei Plerocercoid. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:615-623. [PMID: 34974668 PMCID: PMC8721309 DOI: 10.3347/kjp.2021.59.6.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/27/2021] [Indexed: 11/23/2022]
Abstract
Human sparganosis is a food-borne parasitic disease caused by the plerocercoids of Spirometra species. Clinical diagnosis of sparganosis is crucial for effective treatment, thus it is important to identify sensitive and specific antigens of plerocercoids. The aim of the current study was to identify and characterize the immunogenic proteins of Spirometra erinaceieuropaei plerocercoids that were recognized by patient sera. Crude soluble extract of the plerocercoids were separated using 2-dimensional gel electrophoresis coupled with immunoblot and mass spectrometry analysis. Based on immunoblotting patterns and mass spectrometry results, 8 antigenic proteins were identified from the plerocercoid. Among the proteins, cysteine protease protein might be developed as an antigen for diagnosis of sparganosis.
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Affiliation(s)
- Yan Lu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Jia-Hui Sun
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Li-Li Lu
- The Third Hospital of Shijiazhuang City, Shijiazhuang,
P. R. China
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Peng Song
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Lin Ai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Yu-Chun Cai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
| | - Lan-Hua Li
- School of Public Health, Weifang Medical University, Weifang,
P. R. China
| | - Shao-Hong Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); WHO Collaborating Center for Tropical Diseases; NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention); National Center for International Research on Tropical Diseases; Shanghai,
P. R. China
- Corresponding author ()
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Abstract
A 77-year-old woman presented at our hospital to undergo a close examination of an abnormal shadow which was observed on a chest radiograph. Contrast-enhanced computed tomography (CT) images in the lung window revealed a tortuous tunnel structure (tunnel sign), which was suspected to be the migration path of a parasite. Furthermore, CT images in the mediastinal window showed a linear filling defect from the right inferior pulmonary vein to the venous ostium in the left atrium (migrating sign), which was suspected to be a migrating parasite in the pulmonary vein. Tunnel and migrating signs on chest CT images were helpful in diagnosing pulmonary sparganosis.
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Affiliation(s)
- Mitsuru Matsuki
- Department of Radiology, Kindai University Faculty of Medicine, Japan
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Muigg V, Ruf MT, Schwarzkopf S, Huang S, Denisjuk N, Stürmann A, Ritzler M, Wampfler R, Poppert S, Neumayr A. Case Report: Human Subcutaneous Sparganosis in a Thai Migrant. Am J Trop Med Hyg 2020; 101:1170-1173. [PMID: 31571569 PMCID: PMC6838579 DOI: 10.4269/ajtmh.19-0456] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Human sparganosis is a cestode infection which is neglected as a differential diagnosis outside endemic countries. Diagnosis and therapy may be challenging depending on the clinical presentation and anatomic localization. The disease manifests predominantly as subcutaneous nodule(s) or intracranial mass lesion(s). Infection is primarily acquired by ingesting raw or undercooked amphibian or reptile flesh or by drinking water containing copepods. We report an unusual case of subcutaneous Spirometra erinaceieuropaei sparganosis presenting with two nonmigratory nodules in close proximity to each other on the right thigh of a Thai woman living in Switzerland.
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Affiliation(s)
- Veronika Muigg
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Marie-Therese Ruf
- University of Basel, Basel, Switzerland.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Simon Huang
- DermaZentrum Schaffhausen, Schaffhausen, Switzerland
| | | | - Anna Stürmann
- University of Basel, Basel, Switzerland.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Rahel Wampfler
- University of Basel, Basel, Switzerland.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sven Poppert
- University of Basel, Basel, Switzerland.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andreas Neumayr
- University of Basel, Basel, Switzerland.,Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
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Zhu Y, Ye L, Ding X, Wu J, Chen Y. Cerebral sparganosis presenting with atypical postcontrast magnetic resonance imaging findings: a case report and literature review. BMC Infect Dis 2019; 19:748. [PMID: 31455261 PMCID: PMC6712767 DOI: 10.1186/s12879-019-4396-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/21/2019] [Indexed: 11/28/2022] Open
Abstract
Background Sparganosis, a rare and severe parasitic infection caused by the larvae of Spirometra species or simply sparganum, generally involves subcutaneous tissue or muscle. But occasionally, sparganum can also invade the human brain, resulting in cerebral sparganosis. Case presentation A 33-year-old woman presented with a 10-day history of headache. Postcontrast magnetic resonance imaging (MRI) revealed an irregular lesion with enhancement and the tunnel-shaped focus extending to the contralateral hemiphere. Cerebrospinal fluid (CSF) analysis disclosed pleocytosis (166 cells/μL) and an elevated protein concentration (0.742 g/L). Enzyme-linked immunosorbent assay (ELISA) revealed positive sparganum-specific antibody in both blood and CSF. Finally, the diagnosis of cerebral sparganosis was comfirmed. She received praziquantel treatment and got a favorable outcome during six-month follow-up. Conclusions Irregular enhancement and the tunnel sign that extends to the contralateral hemisphere on postconstrast MRI are unusual presentations of cerebral sparganosis. ELISA for sparganum-specific antibody can help confirm the diagnosis. Although surgery is the preferred treatment for cerebral sparganosis, praziquantel might also achieve satisfying outcomes.
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Affiliation(s)
- Yueli Zhu
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingqi Ye
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiansan Ding
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jimin Wu
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yanxing Chen
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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