Sparganosis Presenting as Cauda Equina Syndrome with Molecular Identification of the Parasite in Tissue Sections

Abstract

A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.

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

“…Furthermore, molecular tools provide additional information to complement the identifi cation of the species of the genus Spirometra. Most genetic studies have been performed in Asia with diagnostic purposes (e.g., Koonmee et al, 2011;Boonyasiri et al, 2013; and for phylogenetic analysis (e.g., Miyadera et al, 2001;Okamoto et al, 2007;Zhang et al, 2014). Until now, there are no reports on molecular studies based on the genus Spirometra in Argentina.…”

Nine Human Sparganosis Cases in Thailand with Molecular Identification of Causative Parasite Species

“…12 Details of clinical characteristics of all patients were shown in Table 1. Subcutaneous sparganosis was six cases followed by CNS involvement (three cases).…”

“…12,13 In this study, we added nine cases (one case was reported previously) 12 of human sparganosis in Thailand with molecular identification of the causative parasite species as S. erinaceieuropaei. In this study, we used partial mitochondrial cox1 gene as a marker and found slight variation among the samples.…”

“…6 -10 In Thailand, there were 55 cases of sparganosis (53 nonproliferative and 2 proliferative) in the period of 1943-2011. 10,12 This report describes nine cases of human sparganosis, caused by Spirometra erinaceieuropaei in a hospital in Thailand during 2001-2012. Diagnosis and identification of causative parasite species was made by histopathological investigations followed by molecular confirmation using formalin-fixed paraffin embedded (FFPE) tissues.…”

Rapid identification of nine species of diphyllobothriidean tapeworms by pyrosequencing

“…Only one study has successfully used morphometric and ultrastructural (surface morphology) egg features to distinguish among the 8 species of diphyllobothriids30. For these reasons, many molecular methods using different genetic markers have been developed for the identification of diphyllobothriid tapeworms: cox1 for Diphyllobothrium 31323334 and S. erinaceieuropaei 1635, sdhB for Sp. proliferum and S. erinaceieuropaei 36, and nad3 for Sp.…”