A Case of Sparganosis That Presented as a Recurrent Pericardial Effusion

Abstract

Sparganosis is caused by a larval tapeworm of the genus Spirometra, which commonly invades subcutaneous tissue, but less frequently invades muscle, intestines, spinal cord, and the peritoneopleural cavity. The authors managed a female patient who presented with a recurrent pericardiopleural effusion and peripheral eosinophilia. The anti-sparganum-specific IgG serum level was significantly higher than normal control levels. In this patient, sparganosis was caused by the ingestion of raw frogs in an effort to control her thyroid disease. The recurrent pericardiopleural effusion and peripheral eosinophilia were controlled by 3 consecutive doses of praziquantel (75 mg/kg/day). The patient is doing well 4 years after presentation. Sparganosis should be considered a rare, but possible cause of recurrent pericardial effusion and peripheral eosinophilia. Immunoserologic testing using enzyme linked immunosorbent assays can be helpful in diagnosing human sparganosis, especially in cases without a subcutaneous lump or mass. Praziquantel is an alternative treatment for sparganosis in surgically-unresectable cases.

Sparganosis Presenting as Pericardial Effusion and Lung Lesions

“…Although a diagnosis of human sparganosis is usually established based on pathologic examinations of such worms, in our case it was impossible to perform a pathologically diagnosis due to the location of the lesions and the patient's refusal to undergo surgery. Concerning the treatment, praziquantel has been reported to be effective for the treatment of sparganosis-related pleural effusion (7-9) and pericardial effusion (14), which was confirmed based on the effectiveness of the treatment of our patient in the present case.…”

“…The thoracic cavity is a rare site for the localization of this parasite in humans. To our knowledge, less than 20 cases of pleural sparganosis in Asia (7-13) and only 1 case of recurrent pericardial effusion and pleural effusion have been reported (14).…”

“…Anti-Sparganum mansoni IgG of the patient's serum were determined using a commercially available ELISA kit (Kangbaide Biological Technology, Shenzhen, China, #S.m 080910) as previously described (14,15). Anti-Sparganumspecific IgG in the patient's serum was higher (OD=0.93± 0.02) than the negative control level (OD=0.15±0.01).…”

“…Sparganum mansoni can also invade muscle, intestines, breast tissue, eyes, spinal cord, brain and, rarely, the thoracic cavity, such as the lung (5), peritoneopleural cavity (6)(7)(8)(9)(10)(11)(12)(13), and pericardium (14).…”

Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant

“…However, an exact species diagnosis based on morphology can only be achieved by feeding the plerocercoid to a definitive host followed by an examination of the adult strobilar stage, which is hardly practicable. 22,23 Metacestodes of different genera, such as the elongated strobilicercus of T. taeniaeformis, bizarre cysticercoids of Hymenolepis nana, and tetrathyridia of Old World Mesocestoides lineatus and New World M. variabilis (all Cyclophyllidea), have to be considered in the differential diagnosis after the helminth has been recovered.…”