CRCM  Vol.2 No.9 , December 2013
Subcutaneous larva migrans of a sparganum in a gnathostomiasis-endemic area
ABSTRACT

We report a case of subcutaneous larva migrans caused by a tape worm (sparganum), a rare and under-recognized food-borne parasitic zoonosis, in Nan Province, Northern Thailand. An obese 56-year-old female presented a 3-month history of an intermittent migrating subcutaneous nodule in the abdomen associated with pain and itching. Physical examination showed a tubal resection scar on the lower abdomen with a swelling and movable irregular, and firm nodule with ill-defined border at the right lower quadrant of abdomen. Blood examination showed slight increased of eosinophil levels (6%). Excisional biopsy showed a viable non-segmented tape worm in the subcutaneous tissue identified by morphological examination and Western blot technique as a sparganum. Surgical removal is recommended for a worm in the subcutaneous connective tissues and superficial muscles.


Cite this paper
Akkarachinorate, K. , Udnan, P. , Chaisiri, K. , Komalamisra, C. , Dekumyoy, P. , Pakdee, W. , Praevanich, R. , Mongkhonmu, S. and Watthanakulpanich, D. (2013) Subcutaneous larva migrans of a sparganum in a gnathostomiasis-endemic area. Case Reports in Clinical Medicine, 2, 530-534. doi: 10.4236/crcm.2013.29138.
References
[1]   Dekumyoy, P., Yoonuan, T. and Waikagul, J. (2013) Gnathostoma. In: Liu, D. Ed., Molecular Detection of Human Parasitic Pathogens, CRC Press, Taylor & Francis Group, Boca Raton, 563-570.

[2]   Waikagul, J. and Diaz Chamacho, S.P. (2007) Gnathostomiasis. In: Darwin, K.D. Ed., Food-Borne Parasitic Zoonoses, Fish and Plant-Borne Parasites, World Class Parasites, Springer, Berlin, 235.

[3]   Miyasaki, I. (1991) An illustrated book of Helminthic Zoonoses. International Medical Foundation of Japan, Shukosha Printing, Fukuoka.

[4]   Muller, R. (2002) Worms and human disease. CABI Publishing, Oxon.
http://dx.doi.org/10.1079/9780851995168.0000

[5]   Cui, J., Li, N., Wang, Z.Q., Jiang, P. and Lin, X.M. (2011) Serodiagnosis of experimental sparganum infections of mice and human sparganosis by ELISA using ES antigens of Spirometra mansoni spargana. Parasitology Research, 108, 1551-1556.
http://dx.doi.org/10.1007/s00436-010-2206-2

[6]   Kim, H., Kim, S.I. and Cho, H.Y. (1984) Serological diagnosis of human sparganosis by means of micro-ELISA. Kisaengchunghak Chapchi, 22, 222-228.
http://dx.doi.org/10.3347/kjp.1984.22.2.222

[7]   Liu, D., Chen, J. and Fang, W. (2013) Spirometra. In: Liu, D. Ed., Molecular Detection of Human Parasitic Pathogens, CRC Press, Taylor & Francis Group, Boca Raton, 287-295.

[8]   Fukushima, T. and Yamane, Y. (1999) How does the sparganosis occur? Parasitology Today, 15, 124.
http://dx.doi.org/10.1016/S0169-4758(99)01405-2

[9]   Cho, S.Y., Bae, J.H. and Seo, B.S. (1975) Some aspects of human sparganosis in Korea. Kisaengchunghak Chapchi, 13, 60-77. http://dx.doi.org/10.3347/kjp.1975.13.1.60

[10]   Anantaphruti, M.T., Nawa, Y. and Vanvanitchai, Y. (2011) Human sparganosis in Thailand: An overview. Acta Tropica, 118, 171-176.
http://dx.doi.org/10.1016/j.actatropica.2011.03.011

[11]   Ausayakhum, S., Siriprasert, V., Morakote, N. and Taweesap, K. (1993) Ocular sparganosis in Thailand. Southeast Asian Journal of Tropical Medicine and Public Health, 24, 603-606.

[12]   Kim, D.G., Paek, S.H., Chang, K.H., Wang, K.C., Jung, H.W., Kim, H.J., Chi, J.G., Choi, K.S. and Han, D.H. (1996) Cerebral sparganosis: Clinical manifestations, treatment, and outcome. Journal of Neurosurgery, 85, 1066-1071. http://dx.doi.org/10.3171/jns.1996.85.6.1066

[13]   Ollaque, W., Ollaque, J. and Guevara de Veliz, A. (1982) Eosinophilic migratory nodular paniculitis (human gnathostomiasis in Ecuador), 1st finding of parasites in South America. Medicina Cutanea Ibero Latino Americana, 10, 73-78.

[14]   Magana, M., Messina, M., Bustamante, F. and Cazarin, J. (2004) Gnathostomiasis: Clinicopathologic study. American Journal of Dermatopathology, 26, 91-95.
http://dx.doi.org/10.1097/00000372-200404000-00001

[15]   Vonghachack, Y., Dekumyoy, P., Yoonuan, T., Sa-nguankiat, S., Nuamtanong, S., Thaenkham, U., Phommasack, B., Kobayashi, J. and Waikagul, J. (2010) Sero-epidemiological survey of gnathostomiasis in Lao PDR. Parasitology International, 59, 599-605.
http://dx.doi.org/10.1016/j.parint.2010.08.007

[16]   Radomyos, P. and Daengsvang, S. (1987) A brief report on Gnathostoma spinigerum specimens obtained from human cases. Southeast Asian Journal of Tropical Medicine of Public Health, 18, 215-217.

[17]   Daengsvang, S. (1980) A monograph on the genus Gnathostoma & gnathostomiasis in Thailand. Southeast Asian Medical Information Center (SEAMIC/IMFJ), Tokyo.

[18]   Faculty of Tropical Medicine. (2012) Annual review. Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok.

[19]   Nontasut, P., Bussaratid, V., Chullawichit, S., Charoensook, N. and Visetsuk, K. (2000) Comparison of ivermectin and albendazole treatment for gnathostomiasis. Southeast Asian Journal of Tropical Medicine and Public Health, 31, 374-377.

 
 
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