The surgical removal of a live tapeworm with an interesting pathologic finding most likely representing the migration path: a case report of cerebral sparganosis

Wang, Peng; Su, Xueying; Mao, Qing; Liu, Qing

doi:10.6061/clinics/2012(07)24

Cited by 5 publications

(4 citation statements)

References 13 publications

(18 reference statements)

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“…Cerebral sparganosis is a severe disease when the plerocercoid larva of Spirometra tapeworm targets the central nervous system [ 21 ]. The larva damages brain tissue and gives rise to neurological function deficits caused by inflammatory attacks and the migration process [ 22 , 23 ]. The natural lifetime of the larva is several decades long in some cases [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy comparison between long-term high-dose praziquantel and surgical therapy for cerebral sparganosis: A multicenter retrospective cohort study

et al. 2018

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BackgroundSparganosis 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 findingsIn 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/SignificanceIn 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.

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Section: Discussionmentioning

confidence: 99%

Efficacy comparison between long-term high-dose praziquantel and surgical therapy for cerebral sparganosis: A multicenter retrospective cohort study

et al. 2018

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“…Cerebral sparganosis is an unusual parasitic illness caused by Spirometra mansoni ( 5 ). Larvae will migrate and damage brain tissue, resulting in neurological dysfunction mediated by inflammation ( 9 , 24 ). Resection of the worm, such as craniotomy or CT-guided stereotactic aspiration is the preferred method for the treatment of cerebral sparganosis ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…Sporadic cases have also been reported in North and South America (3,4), Europe (5), and Australia (6). The clinical symptoms of cerebral sparganosis include headache, seizures, limb paralysis, aphasia, cognitive impairment, and other focal neurologic defects (7)(8)(9). Magnetic resonance imaging (MRI) can reveal some characteristic radiographic features of brain lesions, including aggregated ring-like enhancement, tunnel signs, and migrating lesions (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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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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“…The recently published article on cerebral sparganosis was very interesting ( 1 ). Indeed, Wang et al described a relevant case study of sparganosis, which is an uncommon tapeworm infection that is sporadically reported and can be found in many tropical countries.…”

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confidence: 99%

Cerebral sparganosis

Wiwanitkit

2012

Clinics

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The surgical removal of a live tapeworm with an interesting pathologic finding most likely representing the migration path: a case report of cerebral sparganosis

Cited by 5 publications

References 13 publications

Efficacy comparison between long-term high-dose praziquantel and surgical therapy for cerebral sparganosis: A multicenter retrospective cohort study

Efficacy comparison between long-term high-dose praziquantel and surgical therapy for cerebral sparganosis: A multicenter retrospective cohort study

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

Cerebral sparganosis

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