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sparganosis

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by

Radwa Ramadan

on 5 May 2014

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Transcript of sparganosis

S
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Introduction
Name :

Cestodes in the genus spiromwtra, including
Spirometra mansoni
, S. ranarum, S. mansonoidesand S. erinacei, as well as the aberrant Sparganum proliferum
Sparganosis
length of adult worm :
60 - 100 cm
geographical distribution :
it occurs worldwide specially southeast Asian countries .
-
S
parganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid (older term ) tapeworms belonging to the genus
Spirometra.
-
T
he infection is transmitted by ingestion of contaminated water or ingestion of a second intermediate host such as a frog or snake.
-
H
umans are the accidental hosts in the life cycle, while dogs, cats, and other mammals are definitive hosts.
-
T
he larvae are often referred to by the generic name
Sparganum
, because this stage was previously thought to represent a separate genus.

L
ife
c
ycle

unembryonated eggs passed in feces.
eggs embryonate in water.
coracidia hatch from eggs and are ingested by crusteceans .
procercoid larvae in body cavity of crustaceans.
-infected crustaceans ingested by second intermadiate host (fish,amphibians and reptiles ).
-procercoid larva released from crustacean develops into plerocercoid larva.
Human

definitive hosts eat infected second intermediat host.
adult worm
Habitat
Infective stage
Plerocercoid larva
Diagnostic stage
Unempryonated egg in stool.
Primary Intermediate host:
crustacean (copepods)
Secondary intermediate host:
Definitive host:
Amphibians and reptiles eating animals (cat,dog,lion……etc)
-According to definitive host:
small intestine.
- According to Human:
locates anywhere, including subcutaneous tissue, the central nervous system , eye, urinary tract, pleural cavity, lungs, abdominal viscera and breast.
amphibians ,reptiles,fish and man.
2-raw flesh of undercooked secondary intermediate hosts.
1-contaminated water with crustaceans (copebods) contain the procercoid larva.
Mode of transmission
3-infection may also be caused by the practice of placing poultices of frog or snake flesh on open wounds or other lesions, or the eyes.

This practice is common in many Asian cultures.
Clinical findings
- Sparganosis can cause
intestinal obstruction
, and the parasite has been recovered from the wall of the intestine, the scrotum, the epididymis, ureter, urinary bladder, abdominal cavity and heart.
In subcutaneous tissues:
The larval worms usually grow into irregular nodules and surround tissues, becoming painful. These nodules may persist for months or even years without any symptoms then suddenly become painful.
In the central nervous system:
when spargana settle in the brain or spine a variety of neurological symptoms may occur, including weakness, headache, seizure, and abnormal skin sensations, such as numbness or tingling.
Ocular sparganosis:
-Ocular sparganosis produces an especially intense reaction, with periorbital edema.
-It may result in blindness, as the parasite migrates to the conjunctiva and enters the orbit.
- It causes intense pain, irritation, excessive lacrimation, and marked swelling of the eyelids.
In the inner ear:
If the inner ear is involved, the patient may experience vertigo or deafness.
-The early migratory stages in the development of the sparganum are asymptomatic,
but when it has reached its final site and begins to grow, its presence elicits a painful inflammatory reaction in the surrounding tissues.
-Migrating spargana cause various symptoms depending on the final location in the host.
-Spargana may locate anywhere, including: subcutaneous tissue, eye , the central nervous system , urinary tract , pleural cavity , lungs , abdominal viscera and breast.
sparganum isolated from brain
Laboratory Diagnosis
-Sparganosis is typically diagnosed following surgical removal of the worms, although the infection may also be diagnosed by
identification of eosinophilia
or
identification of the parasite in a tissue biopsy
.
Treatment
Surgical removal
is the treatment of choice for sparganosis. Generally, treatment with mebendazole, albendazole, or praziquantel is not effective to treat infection with these larvae.
-
Cerebral sparganosis
requires surgical excision of the parasite; praziquantel has no effect on adult worms in the central nervous system.
- In rare cases of proliferative sparganosis, prolonged treatment with
mebendazole
and
praziquantel
have been used in addition to surgical removal with mixed success.
Disease:
If such biopsy and excision procedures are not feasible, the antisparganum ELISA (enzyme-linked immunosorbent assay) test may be used.
-
CT
(computed tomography) and
MRI
(magnetic resonance imaging) scans are especially useful for diagnosis of cerebral sparganosis, as they reveal lesions in the brain.
W
e ho
p
e we beni
f
ited y
o
u
By:
Radwa Ramadan
Hager Nabil
Noran Taha
Salma Negm
Sara Mohamed
Full transcript