Sparganosis

Sparganosis
Specialty	Infectious diseases

Sparganosis is a parasitic infection caused by the plerocercoid larvae of the genus Spirometra including S. mansoni, S. ranarum, S. mansonoides and S. erinacei.^[1][2] It was first described by Patrick Manson in 1882,^[3] and the first human case was reported by Charles Wardell Stiles from Florida in 1908.^[4] The infection is transmitted by ingestion of contaminated water, ingestion of a second intermediate host such as a frog or snake, or contact between a second intermediate host and an open wound or mucous membrane.^[5][6] Humans are the accidental hosts in the life cycle, while dogs, cats, and other mammals are definitive hosts. Copepods (freshwater crustaceans) are the first intermediate hosts, and various amphibians and reptiles are second intermediate hosts.^[7]

Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule.^[8] Migration to the brain results in cerebral sparganosis, while migration to the eyes results in ocular sparganosis.^[1][9] Sparganosis is most prevalent in Eastern Asia, although cases have been described in countries throughout the world. In total, approximately 300 cases have been described in the literature up to 2003.^[8][10] Diagnosis is typically not made until the sparganum larva has been surgically removed.^[8] Praziquantel is the drug of choice, although its efficacy is unknown and surgical removal of the sparganum is generally the best treatment. Public health interventions should focus on water and dietary sanitation, as well as education about the disease in rural areas and discouragement of the use of poultices.