Aberrant sparganosis in cat caused by Spirometra mansoni (Cestoda: Diphyllobothriidae): a case report

BACKGROUND

Sparganosis is a rare zoonotic disease caused by plerocercoid larvae of the genera Spirometra or Sparganum (Cestoda: Diphyllobothriidae). The larvae of Spirometra generally do not undergo asexual reproduction, whereas those of Sparganum can induce proliferative lesions in infected tissues. This paper presents an unusual case of proliferative sparganosis due to infection with Spirometra mansoni in a cat, normally considered a definitive host of the species.

CASE PRESENTATION

A 9-year-old male domestic cat was presented with a mass on the right side of the face that underwent progressive enlargement for 1 month. The morphological and histopathological examinations revealed multiple asexual proliferative cestode larvae in the lesions, suggestive of proliferative sparganosis. Next-generation sequencing analysis of formalin-fixed and paraffin-embedded specimens of surgically excised tissue indicated that the worm was Spirometra mansoni.

CONCLUSION

Although S. mansoni a common tapeworm species found in the small intestine of domestic cats and dogs in Japan, proliferative sparganosis is extremely rare. This is the first confirmed case of proliferative sparganosis due to infection with S. mansoni in cat.

Important nutrient sources and carbohydrate metabolism patterns in the growth and development of spargana

BACKGROUND

Sparganosis is a worldwide food-borne parasitic disease caused by spargana infection, which infects the muscle of frogs and snakes as well as many tissues and organs in humans. There are currently no viable treatments for sparganosis. Understanding spargana's nutrition source and carbohydrate metabolism may be crucial for identifying its energy supply and establishing methods of treatment for sparganosis.

METHODS

Using an amino acid analyzer and nutrient concentration detection kits, we assessed nutrient concentrations in the muscles of Fejervarya limnocharis and Pelophylax plancyi infected or not infected with spargana. Quantitative polymerase chain reaction (PCR) was used to quantify the major enzymes involved in five glucose metabolism pathways of spargana developing in vivo. We also used quantitative PCR to assess key enzymes and transcriptome sequencing to explore the regulation of carbohydrate metabolic pathways in vitro in response to different 24-h food treatments.

RESULTS

Infected muscle tissues had considerably higher concentrations of glucogenic and/or ketogenic amino acids, glucose, and glycogen than non-infected muscle tissues. We discovered that the number of differentially expressed genes in Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was larger in low-glucose than in other dietary groups. We examined differences in the expression of genes producing amino acid transporters, glucose transporters, and cathepsins in spargana grown in various nutritional environments. In the normal saline group, only the major enzymes in the tricarboxylic acid cycle (TCA), glycogenesis, and glycogenolysis pathways were expressed. The L-glutamine group had the greatest transcriptional levels of critical rate-limiting enzymes of gluconeogenesis and glycogenesis. Furthermore, the low-glucose group had the highest transcriptional levels of critical rate-limiting enzymes involved in the TCA, glycolytic, and glycogenolysis pathways. Surprisingly, when compared to the in vitro culturing groups, spargana developing in vivo exhibited higher expression of these critical rate-limiting enzymes in these pathways, with the exception of the pentose phosphate pathway.

CONCLUSIONS

Spargana have a variety of nutritional sources, and there is a close relationship between nutrients and the carbohydrate metabolism pathways. It takes a multi-site approach to block nutrient absorption and carbohydrate metabolism pathways to provide energy to kill them.

The serum IgG antibody level as a biomarker for clinical outcome in patients with cerebral sparganosis after treatment

Introduction

Cerebral 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.

Methods

87 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.

Results

Among 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.

Discussion

This 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.

A Human Case of Lumbosacral Canal Sparganosis in China

In this study, we intended to describe a human case of lumbosacral canal sparganosis in People’s Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1–S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1–S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.

[Diagnosis and Treatment for Four Cases of Sparganosis mansoni]

The data of 4 sparganosis mansoni cases were collected from January 2010 to September 2014, and analyzed by descriptive epidemiological methods. Among the cases, 3 cases had a history of eating raw frogs, and 1 case had a history of eating half-cooked frogs and drinking unboiled water. All cased and 3 out of 7 persons eating raw frogs together with case 3 were positive for anti-Sparganum mansoni antibody. 2 patients were cured by operation removal and praziquantel+alhendazole treatment, and the other 2 cases were cured by drugs only.

[Ocular infestation by plerocercoid of Spirometra mansonoides: first case report in Peru]

Plerocercoidosis is a parasitic zoonosis caused by plerocercoid larvae of the genus Spirometra. The larvae migrate through the intestinal wall tissue, by subcutaneous route and can reach different areas of the body like the head, the brain and the eye socket. A case is reported of a 45 year-old man from the Peruvian Amazon with burning sensation associated with conjunctival edema and hemorrhage in the outer eye border of the right eye for eleven months. A localized worm in the right orbital cavity was observed, which was extracted. Morphological and histopathological studies identified it as Spirometra mansonoides localized in the eye, which is the first case reported in Peru.

Cerebral sparganosis: A case report

Sparganosis is a rare parasitic infection in humans caused by a larval cestode of the genus Spirometra. Spargana invade muscle, subcutaneous tissue, the eye, urogenital, and abdominal viscera, but the central nervous system (CNS) is not a frequent site of invasion. Here, we describe an 18-year-old patient with cerebral sparganosis and review data from other cases reported in the medical literature.

[Epidemiological investigation on sparganosis mansoni and animal experiments]

The investigation was made in Luohe City of Henan Province from April to November, 2008. Cyclops were collected and plerocercoids of Spirometra mansoni were examined by microscope. Skin, muscle and internal organs of frogs and tadpoles were checked to detect spargana by naked eye and/or anatomical microscope. Feces of cats and dogs were collected to examine eggs after washing and precipitation. Spargana from tadpoles were collected to infect cats by oral inoculation. Results showed that the infection rate of plerocercoids in cyclops was 3.5% (3/85) and that of spagarna in tadpoles and frogs was 35.9% (120/334) and 16.8% (75/446), respectively. Among 3 cats and 31 dogs investigated, 1 and 6 (19.4%) were found infected respectively. Eggs of Spirometra mansoni were found in feces of cats 12 days after infection. 17 adult worms were found in the intestine of the cat on the 25th day. The habit of eating live tadpoles was found in local residents. The investigation reveals a high prevalence of Spirometra mansoni in the intermediate and final hosts. Eating live tadpoles seems a main reason of getting sparganosis mansoni.

[Investigations on Ligula intestinalis plerocercoid L., 1758 infection of some fishes from Dam Lake Kunduzlar (Kirka, Eskişehir)]

In this study, the presence of Ligula intestinalis plerocercoid in some fish species (Cyprinus carpio, Carassius gibelio, Barbus plebejus, Capoeta tinca, Chondrostoma nasus, Leuciscus cephalus, Alburnus escherichii) from the Kunduzlar Dam, Turkey was investigated between August 2008 and May 2009. By the end of the study, Ligula intestinalis plerocercoid haqs been identified in the body cavity of 3 host fishes [Chondrostoma nasus (1.1%, 5.0+/-0), Leuciscus cephalus (12.1%, 1.5+/-0,6), and Alburnus escherichii (71.5%, 3.0+/-2.1)]. This is the first time that C. nasus, one of these fish species, has been shown to be a host of L. intestinalis plerocercoids in Asia Minor. In addition, minimum-maximum and mean intensity of parasites and infection prevalence were determined using seasonal, sex and size distribution of the host fish species.

[A case report of sparganosis mansoni in the cheek]

Sparganosis mansoni is a kind of parasitic infective disease, rarely seen in clinic. A case of sparganosis mansoni is reported in this article. The patient was a 25-year-old male, who came to Xiangya Hospital on September 26, 2007 because of a mass in the left cheek. A white tape-like body was found during the operation and recognized to be a live parasite. Enzyme linked immunosorbent assay of the serum revealed positivity against Spirometra mansoni. The final identification proved that the white tape-like body was Sparganum mansoni. The disease of this patient was caused by eating raw flesh of frogs infected with the Sparganum mansoni.

Immunoblot findings of calcareous corpuscles binding proteins in cyst fluid of Taenia solium metacestodes

After collecting calcareous corpuscles from plerocercoid of Spirometra mansoni (sparganum), we evaluated the antigenic values of calcareous corpuscles binding proteins obtained from the cyst fluid of Taenia solium metacestodes. Immunoblot analysis revealed that cysticercosis patient sera strongly recognized 10 and 95 kDa calcareous corpuscles binding proteins. This result demonstrated that calcareous corpuscles are bound with major secretory antigenic proteins, which is possibly involved in the secretory pathways of the 10 and 95 kDa proteins presenting in the cyst fluid of T. solium metacestodes.

Subcutaneous and musculoskeletal sparganosis: imaging characteristics and pathologic correlation

OBJECTIVE

To document the imaging characteristics of subcutaneous and musculoskeletal sparganosis.

DESIGN AND PATIENTS

Ten patients with musculoskeletal sparganosis were examined, with a variety of imaging modalities including MRI (n=6), ultrasonography (n=8), plain radiography (n=7) and CT (n=1). Pathologic correlation was carried out in all cases.

RESULTS

Nine lesions involved soft tissues, of which seven were in the thigh, two in the trunk and one involved a vertebral body. The majority of the lesions in soft tissue were confined to the subcutaneous layer but two extended deep into underlying muscles. Sonography revealed low-echoic serpiginous tubular tracts (8/8), and an intraluminal echogenic structure (4/8). MRI revealed multiple serpiginous tubular tracts and peripheral rim enhancement. Two patients showed perilesional soft tissue edema. Pathologically, the lesion consisted of a larva surrounded by three layers of inflammation: an inner epithelioid granulomatous cell layer, middle chronic inflammatory cell layers, and an outer fibrous layer.

CONCLUSION

The study suggests that if serpiginous tubular tracts are seen at imaging studies, musculoskeletal sparganosis should be included in the differential diagnosis.

Cestode larva (Sparganum) in the anterior chamber of the eye

The first case of intraocular sparganosis presenting as endophthalmitis is reported with a live plerocercoid larva of Spirometra lodged in the anterior chamber of the eye of a man in India. The larva was identified histologically.

Proliferating larval cestodiasis: report of a case

A 72-year-old Filipino man who had emigrated to Canada had an abdominal infection with a proliferating acephalic larval cestode. Small, irregularly shaped parasites were within the substance of a lymph node, where they provoked a fibrogranulomatous and eosinophilic reaction. The parasite is described and is identified as an undifferentiated sparganum or tetrahyridium based upon comparison with two similar parasites from patients in Taiwan and Paraguay.

A lipogenic effect in intact male hamsters infected with plerocercoids of the tapeworm, Spirometra mansonoides

Plerocercoids of the tapeworm, Spirometra mansonoides, produce a potent growth stimulating substance which is active in several species of mammals. While most of the actions of the plerocercoid growth factor (PGF) are similar to those of growth hormone (GH), lipid metabolism is one area where their actions are not alike. This report demonstrates that plerocercoid infection not only stimulates growth of intact male hamsters but is lipogenic as well. The lipogenic effects of plerocercoid infection were demonstrated by increases in epididymal fat pad weights, serum triglycerides, cholesterol, and total lipid. The livers of the plerocercoid-infected hamsters also had more cholesterol and more lipid phosphorus than controls. Incorporation studies using [2-14C]acetate showed that infected hamsters incorporated significantly higher levels of the radionuclide in their livers and serum after 1 hr than the controls. The lipogenic effect of plerocercoid infection is distinctly unlike the reported lipolytic action of GH and the lack of any stimulation of [2-14C]acetate incorporation into the epididymal fat pads is unlike the reported acute actions of insulin as well.

Sparganosis in the United States. Report of a case

A 20-year-old Philadelphia woman (recently moved from South Carolina) had sparganosis of her lower anterior abdominal wall. In the United States sparganosis occurs when man enters the life cycle of dog or cat tapeworms of the genus Spirometra. Most of the American cases have been reported from the southeastern United States, and the most probable source of infection is contaminated drinking water. Sporadic cases have also been seen in other parts of the country. If the pathologist is familiar with the morphology of spargana, the gross and histologic features are sufficient for identification of genus Spirometra.

A comparison of the metabolic effects of bovine growth hormone and growth factor from Spirometra mansonoides on rat liver in vivo

The effects of bovine growth hormone(GH) and Spirometra growth factor (SGF) on the in vivo concentrationions of glycolytic and citricacid (TCA) cycle intermediates in rat liver were investigated. The effects of these agents on the mitochondrial and cytoplasmic redox states, liver phosphorylation states, and adenylate kinase activity were also evaluated. The effects of SGF were studied in both normal and hypophysectomized rats,wheras GH effects ere examined only in hypophysectomized rats. Growth homrone(0.25mg/rat) was injected dayily for 9 days...