Three cases of cutaneous sparganosis

Abstract

Case 1 A 64‐year‐old man visited our clinic complaining of an asymptomatic nodule on his right thigh, detected 10 days previously. Physical examination revealed a solitary subcutaneous nodule, 1.5 cm in diameter on his right thigh. Twenty years previously the patient had undergone surgery to remove a ‘‘worm’' from his leg. The patient stated that he enjoyed eating raw snakes. On performing excisional biopsy of the lesion, the white, flat, shiny sparganum was detected and removed (Fig. la). The histopathological study of the biopsy specimen showed several encapsulated, mummified sparganum pieces and dense lymphohistiocytic infiltration along with neutrophils and eosinophils (Fig. lb). 1 (a) A flat, band‐like, white glistening sparganum being removed from the right thigh of case 1. (b) An encapsulated, mummified sparganum piece showing degenerated internal organs (hematoxylin and eosin × 40) Case 2 A 53‐year‐old woman was noted to have an asymptomatic nodule on her inguinal area for over 3 years. Although the lesion was asymptomatic the patient dubiously described the lesion as creeping upward in a linear pattern at negligible speed. The patient denied ingesting snakes or any kind of exotic food, yet admitted to drinking from springs occasionally as she climbed mountains. On physical examination, a relatively ill‐defined soft nodule was detected on her left inguinal area. While performing excisional biopsy of the lesion, an 8 cm sized white, flat sparganum was noticed and removed (Fig. 2). The histopathological study revealed a panniculitis infiltrated with eosinophil and lymphohistiocytes. 2 An 8‐cm white, flat larva from case 2 Case 3 A 41‐year‐old man presented with an asymptomatic nodule on his right thigh detected 3 years previously. The patient had eaten raw snakes about 10 years earlier. The clinical feature of the lesion was a solitary pea‐sized nodule without any change in color on overlying skin. The biopsy from the lesion disclosed fragments of a larval cestode with morphologic features of sparganum (Fig. 3). 3 Cross section of Sparganum, shows tegument (T), numerous smooth muscle fibers (M), excretory ducts (E) and calcareous bodies (C) (hematoxylin and eosin × 100)

Multiple papules and nodules on the face and neck caused by the larvae of an unknown nematode: A noncreeping type eruption

“…5,6 CLM may also present as a nodular migratory panniculitis instead of creeping eruptions. [7][8][9][10][11][12] In our case, the somatic musculature in the larvae was of the meromyarian type, in which a few muscle cells are located beneath the cuticle. Meromyarian nematodes are members of the order Rhabditida.…”

“…1 Patients with CLM may exhibit superficial or creeping eruptions, 2-4 folliculitis, 5,6 and migratory swellings or subcutaneous nodules. [7][8][9][10][11][12] Various parasites have been reported to be the cause of CLM, but it is not always possible to identify the organism because the larvae found in microscopic sections frequently lack characteristic morphologic features. We report a case with cutaneous larval infestation showing noncreeping, multiple eruptive papules and nodules on the face and neck caused by the larvae of an unknown nematode.…”

Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant

“…Surgical excision remains the definitive treatment modality, but antiparasitic chemotherapy with praziquantel, mebendazole, or topical ethanol has been tried with some success. 19,32 The surgical approach without anthelminthic therapy was successful in our case. Regular follow-up examinations for 1 year did not show any additional symptoms of infection.…”

Sparganosis of the cauda equina: A rare case report and review of the literature

“…[2] In the lifecycle the intermediate hosts are freshwater fish, amphibians and reptiles. [7] Acute angioedema or chronic skin rash may also play an important role in parasitic infection. [6] The mechanism of the migration of the larvae to the central nervous system (CNS) is still unclear.…”