Cerebral sparganosis

Abstract

A 38-year-old Japanese man presented with a 2-year history of cerebellar ataxia, fever, and headaches. MRI revealed migration of the lesion (figure, A-C). CSF cytology showed eosinophilic meningitis (figure, D); serum and CSF ELISA were positive for Spirometra erinaceieuropaei.Human sparganosis is a rare parasitic infection by the larval cestode of Spirometra that results from ingesting the plerocercoid harbored in frogs, snakes, and chickens. Reported worldwide, sparganosis is most prevalent in Southeast and Eastern Asia. The diagnosis is suggested by a wandering lesion, especially in endemic areas; the tunnel sign on postcontrast MRI is characteristic.1 The preferred treatment is the surgical removal of live worm.

Migration: A Notable Feature of Cerebral Sparganosis on Follow-Up MR Imaging

“…The larva can survive in a tunnel, encapsulated by hyperplastic fibrous tissue for several years, 2,18 or it can penetrate the wall of the granuloma and move into the brain. Therefore, some researchers call it the wandering lesion, 17 and we concur with this point of view.…”

“…8,13-17 Shirakawa et al 17 reported the migration of the lesion from the cerebellar hemisphere to the vermis during 7 weeks, which was the shortest reported time interval. In our opinion, the migrated lesion detected in a short time interval was presumably due to the short moving pathway and opportune MR imaging examination.…”

“…13,14 Until now, there were only a few cases [15][16][17] of cerebral sparganosis migration reported in the literature. In this study, we demonstrate the migration of cerebral sparganosis and describe its patterns on follow-up MR imaging studies.…”

Research Note. Cox-1 gene sequence of Spirometra in Pampas foxes from Argentina

“…This human disease can arise from intake of invertebrates containing procercoid larvae or of reptiles or amphibians containing plerocercoid larvae. The larvae can remain in the subcutaneous tissue and sometimes invade other tissues, including the central nervous system (e.g., Magnino et al, 2009;Shirakawa et al, 2010). Ijima (1905) reported the proliferative human sparganosis caused by the larval cestode Sparganum proliferum, but did not fi nd the adult stage of the parasite.…”

Sparganosis of the brain: a case report and brief review

“…Sporadic human sparganosis has been documented worldwide, but the prevalence is higher in Asia countries, especially in China, Thailand, Japan and South Korea [3,5,8,9] . The most common target places in humans for spirometra are subcutaneous tissue or muscle [10] , cerebral sparganosis is relatively rare but represents the most severe type [11] , characterized by symptoms like seizures and the wandering sign in magnetic resonance imaging (MRI) scanning [12] .…”