Korean Circ J.  2011 Jan;41(1):38-42. 10.4070/kcj.2011.41.1.38.

A Case of Sparganosis That Presented as a Recurrent Pericardial Effusion

• Lee JH
• Kim GH
• Kim SM
• Lee SY
• Lee WY
• Bae JW
• Shin KS
• Hwang KK
• Kim DW
• Cho MC

• KMID: 2225153
• DOI: http://doi.org/10.4070/kcj.2011.41.1.38

Abstract

Sparganosis is caused by a larval tapeworm of the genus Spirometra, which commonly invades subcutaneous tissue, but less frequently invades muscle, intestines, spinal cord, and the peritoneopleural cavity. The authors managed a female patient who presented with a recurrent pericardiopleural effusion and peripheral eosinophilia. The anti-sparganum-specific IgG serum level was significantly higher than normal control levels. In this patient, sparganosis was caused by the ingestion of raw frogs in an effort to control her thyroid disease. The recurrent pericardiopleural effusion and peripheral eosinophilia were controlled by 3 consecutive doses of praziquantel (75 mg/kg/day). The patient is doing well 4 years after presentation. Sparganosis should be considered a rare, but possible cause of recurrent pericardial effusion and peripheral eosinophilia. Immunoserologic testing using enzyme linked immunosorbent assays can be helpful in diagnosing human sparganosis, especially in cases without a subcutaneous lump or mass. Praziquantel is an alternative treatment for sparganosis in surgically-unresectable cases.

Keyword

Sparganosis; Pericardial effusion; Praziquantel

MeSH Terms

Cestoda
Eating
Eosinophilia
Female
Humans
Immunoglobulin G
Intestines
Muscles
Pericardial Effusion
Praziquantel
Sparganosis
Spinal Cord
Spirometra
Subcutaneous Tissue
Thyroid Diseases
Immunoglobulin G
Praziquantel

Figure

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  Fig. 1 Images obtained at the time of first admission. A: chest radiograph showed mild cardiomegaly without pulmonary congestion and blunting of the left costrophrenic angle. B and C: echocardiogram demonstrated pericardial effusion with a maximal depth of 12 mm without hemodynamic significance. D: chest CT revealed pericardial effusion and a small amount of pleural effusion, but no other notable findings.

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  Fig. 2 Images obtained during the second admission. A: chest radiography showed increased amounts of pleural effusion. B: increased number of eosinophils was observed in the pleural fluid (black arrows) (wright stain, ×1,000). C and D: follow-up echocardiogram and chest radiograph before discharge showed reduced amounts of pleural effusion and the absence of a pericardial effusion.

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  Fig. 3 (A) chest radiograph and (B) echocardiogram obtained 6 weeks after 3 consecutive doses of praziquantel showed no evidence of a pericardiopleural effusion.

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