Human proliferative sparganosis update.

Proliferative sparganosis is one of the most bizarre and mysterious parasitic diseases ever described. The causative parasite is Sparganum proliferum, which is a pseudophyllidean cestode distinct from Spirometra tapeworms. Here we overview this rare but fascinating disease with the all original case reports on human patients published in the last 115 years. Proliferative sparganosis is clearly divided into two disease types, cutaneous and internal proliferative sparganosis. Cutaneous type starts with a skin eruption caused by the dermal invasion of a sparganum. Skin lesion progresses to larger areas of the body if left untreated. Various internal organs and body wall can be eventually affected. The clinical symptoms of patients in this group are very similar to each other. Molecular data suggest that cutaneous proliferative sparganosis is caused by S. proliferum of which genetic variation is limited, regardless of the time or localities of the emergence of patients. Internal proliferative sparganosis, on the other hand, is much more heterogeneous. Some cases show aggressive infection in internal organs, while others show only restricted lesions. Some of the cases that had been cited as proliferative sparganosis in the past literature were removed from the list, because they were judged as cyclophyllidean tapeworm infections. DNA sequencing is mandatory for the definite diagnosis of proliferative sparganosis. The Venezuelan strain of S. proliferum is maintained in experimental mice in Japan, which is fully prepared for the experimental study with advanced technologies in modern molecular biology.

Clinical Features of Pulmonary Sparganosis.

BACKGROUND: Sparganosis is an infectious disease caused by the sparganum of Spirometra species, which seldom invades the respiratory system. The aim was to describe the clinical features and outcomes of pulmonary sparganosis. METHODS: A total of 40 patients with pulmonary sparganosis were reviewed, including 12 cases known from this experience and 28 cases reported in the literature. RESULTS: Among these 40 patients at an average age of 45.4 ± 11.1 years (men 29), 34 (85%) had a history of ingesting raw or undercooked meat (mainly frogs or snakes). The top 3 symptoms were coughing (60.0%), fever (57.5%) and chest pain (42.5%). Peripheral blood eosinophilia was found in 30 cases (75%). Lesions were located in lung parenchyma, airway, pleura and pulmonary vessels of the patients. Thirty-one patients (77.5%) had pleural effusion. The diagnosis was established by antisparganum antibody test in 30 cases (75%) and by pathology in 9 cases (22.5%); 1 case was not mentioned. Among the 35 cases with follow-up information, 2 treated with complete surgical removal and 31 with oral administration of praziquantel had no recurrence; the remaining 2 died without effective treatments. CONCLUSIONS: As an extremely rare and life-threatening parasitic zoonosis, pulmonary sparganosis should be diagnosed by combining the epidemiology, patient history, eosinophilia and the positive antisparganum antibody test result together if no worm was detected. Oral praziquantel is considered to be an effective treatment.

A waterborn zoonotic helminthiase in an Italian diver: a case report of a cutaneous Sparganum infection and a review of European cases.

Many waterborne helminthes are opportunistic parasites that can travel directly from animals to man and may contain forms capable of penetrating the skin. Among these, Sparganum is the pseudophyllidean tapeworm that belongs to the genus Spirometra, which is responsible for parasitic zoonosis; it is rarely detected in Europe and is caused by the plerocercoid infective larva. Thus far, only six cases of cutaneous and ocular sparganosis have been reported in Europe; two and four cases have occurred in France and Italy, respectively. Herein, we describe a new case of sparganosis in Italy that affected a male diver who presented to the Bambino Gesù Children's Hospital of Rome. The patient's skin biopsy was submitted to the Parasitology department who, in consultation with Pathology, concluded that the morphologic and microscopic findings were those of Sparganum spp. larvae. The patient recovered following a single dose of 600 mg praziquantel.

Increased FDG uptake of the bone marrow mimicking malignancy in a patient of eosinophilia secondary to Sparganum mansoni infection.

Secondary eosinophilia is usually associated with parasitosis in Third World countries. We present a case of eosinophilia secondary to Sparganum mansoni infection showing multifocal FDG uptake in the axial bones mimicking malignancy. Bone marrow aspirations and biopsy revealed remarkable proliferation of eosinophils which may be related to the increased FDG uptake. This case indicates that secondary eosinophilia associated with parasitosis may be one cause of diffuse FDG uptake in the bone marrow.

Do heavy burdens of Schistocephalus solidus in juvenile threespine stickleback result in disaster for the parasite?

The diphyllobothriidean cestode Schistocephalus solidus typically infects threespine sticklebacks that are too small to allow the parasite to reach a mature size. As a result, the parasite must allow further growth of its host to reach the size at which it becomes competent to infect and reproduce in the definitive host. At times, however, intensity of infection can be high, leading to crowding among parasites and to heavy burdens causing mortality among hosts. Our data show that, during a previously observed epizootic, large percentages of plerocercoids (average 75% per host, 82% among all parasites pooled) did not grow to become massive enough in 1-yr-old threespine sticklebacks to be capable of establishment and maturation in the definitive host. Massive deaths of 1-yr-old sticklebacks due to infection during the epizootic resulted in the great misfortune of a disaster for a large number of parasites, resulting in dramatically reduced transmission of S. solidus.

Case report: Lower extremity sparganosis in a bursa.

BACKGROUND: Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. CASE DESCRIPTION: We report the case of a 67-year-old man with a mass over the anteromedial surface of the proximal extremity of the tibia. We surgically excised a bursa containing Spirometra larvae. LITERATURE REVIEW: Sparganosis is a rare parasitic infection. We found no cases of lower extremity sparganosis combined with bursitis reported in the literature. PURPOSES AND CLINICAL RELEVANCE: Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among patients who frequently have consumed mountain water or raw snakes or frogs.

[Effect of physicochemical factors on infectivity of Spirometra mansoni plerocercoid].

OBJECTIVE: To observe the effect of different physicochemical factors on the infectivity of Spirometra mansoni plerocercoids. METHODS: The muscle samples with plerocercoids taken from Rana nigromaculata (about 1 cm3 each piece) were treated with different temperature (-20 degrees C, 4 degrees C, 37 degrees C and 56 degrees C) or different concentrations of ethanol (20%, 30%, 40%, 50% and 60%) for 1, 2 or 3 h, or soaked in ginger juice, vinegar (total acid concentration of 4.5%, pH 3.05) or soy sauce (containing 19.3% NaCl) for 3, 6, 12 or 24 h. The muscle with plerocercoids treated with normal saline under 20 degrees C served as control. 30 plerocercoids were used under each condition and fed to 10 mice averagely (3 larvae/mouse). Another 20 plerocercoids with frog meat were comminuted for 3 min then fed to 10 mice. One week later, the mice were sacrificed to collect the parasitic plerocercoids and the number of positive mice and plerocercoids was recorded. RESULTS: None of the mice fed with plerocercoids treated under -20 degrees C for 2 h was infected. All the mice fed with plerocercoids treated under 56 degrees C for 2 h and 3 h were infected. The percentage of infective plerocercoids was 60% (18/30) and 43% (13/30), respectively, considerably lower than those of the control (90%, 27/30) (P < 0.05). None of the mice fed with plerocercoids soaked in 60% ethanol for 2 h was infected. All the mice fed with plerocercoids soaked in 60% ethanol for 1 h, or in 50% ethanol for 2 h or 3 h were infected. The percentage of infective plerocercoids was 60% (18/30), 57% (17/30), and 50% (15/30), respectively, considerably lower than those of the control (93%, 28/30) (P<0.05). None of the mice fed with plerocercoids soaked in vinegar for 24 h, or soy sauce for 6 h was infected. The infectivity of the plerocercoids treated by ginger juice for 24 h was similar to the control (P>0.05). Among the ten mice fed with comminuted frog meat with plerocercoids, five were infected with 6 plerocercoids. CONCLUSION: Treatment with -20 degrees C or 60% ethanol for 2 h, soy sauce for 6 h, or vinegar for 24 h can destroy the infectivity of plerocercoids in 1 cm3 frog muscle.

Lepidopterismo por Hylesia nigricans ( Mariposa negra ). Investigacion y accion preventiva en Buenos Aires / Lepidopterism due to the butterfly Hylesia nigricans. Preventive research-intervention in Buenos Aires

En el barrio El Pato,municipio de Berazategui, provincia de Buenos Aires, se realizó una investigación-acción preventiva contra la “mariposa negra” Hilesia nigricans, luego del aumento de consultas espontâneas por dematitis inespecífica. La incidência, durante el verano del año 2001, se estimo mediante una encuesta semiestructurada. En noviembre de 2002, se roció con Bacillus thuringiensis el arbolado público, evaluándose su efecto insecticida en campo y en laboratorio. El impacto se estimó mediante una encuesta pos-intervención en marzo de 2002. La distribución por edad, signos clínicos, persistência (11 días) y estacionalidad de los casos ( enero-febrero) fue consistente con dermatitis por H . nigricans. La mortalidad de larvas a las 96 horas del rociado fue del 100%. Las tasas de incidencia de dermatitis antes y después de la intervención fueron de 10.3% y 1.8% respectivamente. La acción coordinada de agentes nacionales, provinciales y locales permitió identificar el problema, diseñar investigaciones operacionales, y aplicar una estratégia de control preventivo, transferible por sus mismos efectores a la comunidad.

Lepidopterismo por Hylesia nigricans ( Mariposa negra ). Investigacion y accion preventiva en Buenos Aires / Lepidopterism due to the butterfly Hylesia nigricans. Preventive research-intervention in Buenos Aires

En el barrio El Pato,municipio de Berazategui, provincia de Buenos Aires, se realizó una investigación-acción preventiva contra la ¶mariposa negra÷ Hilesia nigricans, luego del aumento de consultas espontÔneas por dematitis inespecífica. La incidÛncia, durante el verano del año 2001, se estimo mediante una encuesta semiestructurada. En noviembre de 2002, se roció con Bacillus thuringiensis el arbolado público, evaluándose su efecto insecticida en campo y en laboratorio. El impacto se estimó mediante una encuesta pos-intervención en marzo de 2002. La distribución por edad, signos clínicos, persistÛncia (11 días) y estacionalidad de los casos ( enero-febrero) fue consistente con dermatitis por H . nigricans. La mortalidad de larvas a las 96 horas del rociado fue del 100%. Las tasas de incidencia de dermatitis antes y después de la intervención fueron de 10.3% y 1.8% respectivamente. La acción coordinada de agentes nacionales, provinciales y locales permitió identificar el problema, diseñar investigaciones operacionales, y aplicar una estratégia de control preventivo, transferible por sus mismos efectores a la comunidad. (AU)

A 78 kDa glucose-regulated protein gene of Spirometra erinacei plerocercoid induced by chemical and physiological stresses.

To adapt to different environmental conditions between poikilothermic and homeothermic hosts, the plerocercoid of Spirometra erinacei (sparganum) might express a variety of biologically active molecules. We have identified a 78 kDa glucose-regulated protein of the sparganum (SpGrp78) by differential display of mRNA, employing RNAs each from sparganum adjusted at 9 degrees C and 37 degrees C. A full-length cDNA of 2148 bp encodes for a protein of 651 amino acids with a predicted molecular mass of 71 610 Da and shares molecular characteristics with heat-shock protein 70, including a putative ATP binding site, signal peptide cleavage site and endoplasmic reticulum retention signal. Phylogenetic analysis revealed that SpGrp78 was mostly related to those of Echinococcus multilocularis and E. granulosus. Expression of SpGrp78 mRNA increased approximately 7-fold by inhibition of glycosylation by tunicamycin, 2-fold by temperature-shift from 9 degrees C to 37 degrees C and slightly by pH-shift to 4.0 or 5.5. These results suggested that induction of SpGrp78 mRNA is related to the functional role of SpGrp78 as a molecular chaperone when the parasite adapts to a new host environment.

Changes in metabolism and behaviour of the freshwater copepod Cyclops strenuus abyssorum infected with Diphyllobothrium spp.

In a population of copepods (Cyclops strenuus abyssorum), with a naturally high prevalence of infection with procercoids of Diphyllobothrium spp., no difference in body size was found between infected and uninfected hosts. However, a significant reduction in the reproductive capacity of infected females was observed, 87% of uninfected females having developed eggs in their gonads and sacs compared with 21% of infected females. The feeding rate of infected copepods was relatively high soon after infection occurred, but gradually decreased to less than half that of uninfected animals. Respiration rate was also lower in infected copepods. Infected copepods showed reduced motility and impaired escape responses, which is likely to make them more susceptible to predation.

Un caso de esparganosis humana en Argentina / A case of human sparganosis in Argentina

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.(Au)

[A case of human sparganosis in Argentina]. / Un caso de esparganosis humana en Argentina.

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.

Ocular sparganosis: a cause of subconjunctival tumor and deafness.

We report a patient with a subconjunctival mass lesion caused by a larva of Spirometra sp. The parasite, 44 cm long and 1.0 mm wide, was removed intact and alive with complete preservation of the patient's vision. The mode of infection was probably through consumption of contaminated drinking water.

Effects of putative neurotransmitters on the motor activity of Spirometra mansonoides.

5-Hydroxytryptamine (5-HT), epinephrine, and dopamine strongly stimulated the motor activity of larval Spirometra mansonoides. By contrast, a cholinomimetic agent, arecoline, paralyzed the worms. There was some pharmacological specificity among the agonists but not with various antagonists. Acetylcholinesterase activity was present in both larval and adult Spirometra.

Role of growth hormone in improving animal production.

Pituitary growth hormone (GH) has considerable potential as an anabolic agent in animal production. For example, pigs treated with GH will grow faster (i.e. deposit protein), require less feed per unit of body weight gain, and will have less carcass fat than untreated animals. Lactating cows will produce more milk with less feed. It is likely, though not completely established, that young cattle will also respond to GH treatments. Most of the information on the mode of action of GH has been obtained with laboratory rather than farm animals. The hormone affects almost all aspects of metabolism although the specific mechanism for these effects is still not understood. Stimulation of protein accretion is reflected by increased nitrogen retention and incorporation of radioactive amino-acids into tissue proteins. An increased rate of protein synthesis is thought to be a result of enhanced ability of ribosomes to translate messenger RNA. GH increases polyamine synthesis by increased ornithine decarboxylase activity; RNA synthesis by increasing RNA polymerase and DNA synthesis by increased DNA polymerase. Cell division is stimulated in several tissues (e.g. muscle and lymphoid tissue). In vivo GH lowers the respiratory quotient indicating an increased oxidation of fatty acids. The numbers of fat cells do not change but the fat cells are reduced in size. The stimulating effects of GH on skeletal tissue, and perhaps other tissues as well, is mediated by the formation of at least three peptides called somatomedins. GH is a protein with a molecular weight of about 22,000 and contains 191 amino-acid residues. The amino-acid sequence varies with the species. GH isolated from one species is not always effective in a different species. Use of GH isolated from pituitaries does not appear to be economically feasible. A chemical synthesis for human GH has been accomplished. However, biological activity equivalent to the native hormone has not been unequivocally established. Synthesis of bovine or porcine GH is feasible but will be expensive. A partial sequence of GH with 39 amino-acid residues has some biological activity. Synthesis of this shorter peptide would be considerably less expensive. Since proteins generally are not active orally, an economic procedure for prolonged parenteral administration would have to be devised. Althernative approaches would be the stimulation of endogeneous production of GH with hypothalmic GH releasing factor. This factor has not been identified but is probably a small peptide. Agents such as arginine, DOPA, and prostaglandins, which are known to stimulate GH release under some conditions, could also be considered. Another approach would be the implantation of sparganum from the spirometra family (a flatworm). This treatment is known to mimic GH effects in the rat. Implantation of a GH producing tumour could also be considered. Clearly these latter suggestions are quite speculative and would present some obvious problems...