Abstract
Sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni, also called “sparganum.” In human hosts, the Spirometra mansoni larva commonly targets the subcutaneous tissue or muscle. Sometimes it can also migrate into the brain, resulting in cerebral sparganosis, mainly characterized by focal neurological symptoms such as seizures and radiological “wandering lesions” on magnetic resonance images (MRIs). Clinical cases of cerebral sparganosis have been reported worldwide, mainly in Asian countries, but also in North America, South America and Australia. Only two cases have been previously reported in Europe. A 29-year-old male from Bolivia, who lived in Spain, presented to our service for seizures and a multicystic brain lesion, initially suspected to be a dysembryoplastic neuroepithelial tumor (DNET). He underwent gross total resection of the mixed solid/cystic lesion. Pathology revealed gliosis, multiple interconnected cystic cavities with fibrous walls, inflammatory cell infiltration and no necrotizing granulomatous reaction. Inside the cavities, a parasitic form was identified as the larva of the cestode Spirometra mansoni. At 1-year follow-up, the patient had no deficits and was seizure free. Clinicians should be alerted to the possible existence of this rare entity in Europe, especially in patients from endemic areas with a possible infection history as well as “wandering lesions” on the MRI.
References
Anders K, Foley K, Stern E, Brown WJ (1984) Intracranial sparganosis: an uncommon infection. Case report. J Neurosurg 60:1282–1286
Chamadol W, Tangdumrongkul S, Thanaphaisal C, Sithithaworn P, Chamadol N (1992) Intracerebral hematoma caused by sparganum: a case report. J Med Assoc Thail 75:602–605
Cummings TJ, Madden JF, Gray L, Friedman AH (2000) Parasitic lesion of the insula suggesting cerebral sparganosis: case report. Neuroradiology 42:206–208
Deng L, Xiong P, Qian S (2011) Diagnosis and stereotactic aspiration treatment of cerebral sparganosis: summary of 11 cases. J Neurosurg 114:1421–1425
Fan KJ, Pezeshkpour GH (1986) Cerebral sparganosis. Neurology 36:1249–1251
Gonzenbach RR, Kong Y, Beck B, Buck A, Weller M, Semmler A (2013) High-dose praziquantel therapy for cerebral sparganosis. J Neurol 260:1423–1425
Holodniy M, Almenoff J, Loutit J (1991) Cerebral sparganosis: case report and review. Rev Infect Dis 13:155–159
Hong D, Xie H, Zhu M, Wan H, Xu R, Wu Y (2013) Cerebral sparganosis in mainland Chinese patients. J Clin Neurosci 20:1514–1519
Jones MC, Agosti MR, D'Agustini M, Uriarte V, Drut R (2013) Cerebral sparganosis in a child: case report. Arch Argent Pediatr 111:1–4
Kwon JH, Kim JS (2004) Sparganosis presenting as a conus medullaris lesion—case report and literature review of the spinal sparganosis. Arch Neurol 61:1126–1128
Li MW, Song HQ, Li C, Lin HY, Xie WT, Lin RQ, Zhu XQ (2011) Sparganosis in mainland China. Int J Infect Dis 15:54–56
Mitchell A, Scheithauer BW, Kelly PJ, Forbes GS, Rosenblatt JE (1990) Cerebral sparganosis. Case report. J Neurosurg 73:147–150
Munckhof WJ, Grayson ML, Susil BJ, Pullar MJ, Turnidge J (1994) Cerebral sparganosis in an East Timorese refugee. Med J Aust 161:263–264
Pampiglione S, Fioravanti ML, Rivasi F (2003) Human sparganosis in Italy: case report and review of the European cases. APMIS 111:349–354
Pujatti D (1953) Un caso di sparganosi umana. Riv Parassitol 14:213–217
Rengarajan S, Nanjegowda N, Bhat D, Mahadevan A, Sampath S, Krishna S (2008) Cerebral sparganosis: a diagnostic challenge. Br J Neurosurg 22:784–786
Shirakawa K, Yamasaki H, Ito A, Miyajima H (2010) Cerebral sparganosis: the wandering lesion. Neurology 74:180
Song T, Wang WS, Zhou BR, Mai WW, Li ZZ, Guo HC, Zhou F (2007) CT and MR characteristics of cerebral sparganosis. AJNR Am J Neuroradiol 28:1700–1705
Walker P, Cooper NK, Brandis A (2007) Cerebral sparganosis presenting as grand mal epilepsy. J R Army Med Corps 153:189–190
Wong CW, Ho YS (1994) Intraventricular haemorrhage and hydrocephalus caused by intraventricular parasitic granuloma suggesting cerebral sparganosis. Acta Neurochir 129:205–208
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Lo Presti and co-workers describe a case of cerebral sparganosis, a severe parasitic infection mainly seen in Asia and only described twice—now three times—in Europe. Even though the present case is not really a European one—the 29-year-old male was from Bolivia, now living in Spain—the careful documentation of the case along with the aspect of enlarging our repertoire of differential diagnoses warrants its publication.
Marcus Reinges
Giessen, Germany
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Lo Presti, A., Aguirre, D.T., De Andrés, P. et al. Cerebral sparganosis: case report and review of the European cases. Acta Neurochir 157, 1339–1343 (2015). https://doi.org/10.1007/s00701-015-2466-9
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DOI: https://doi.org/10.1007/s00701-015-2466-9