Korean J Obstet Gynecol.  2010 Aug;53(8):746-751. 10.5468/kjog.2010.53.8.746.

Vulva sparganosis misdiagnosed as a Bartholin's gland abscess

• Kim TH
• Lee HH
• Chung SH
• Yi BH
• Kwak JJ
• Nam HS
• Cha SH

• KMID: 2273995
• DOI: http://doi.org/10.5468/kjog.2010.53.8.746

Abstract

Sparganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid tapeworms belonging to the genus Spirometra, as first described by Manson in 1882. The infection is transmitted by ingestion of contaminated water, frogs, and snakes, and contact between a second intermediate host and an open wound or mucus membranes. Humans are accidental hosts in the life cycle, but dogs, cats, and other mammals are definitive hosts. Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. We misdiagnosed vulva sparganosis as a Bartholin's gland abscess. The patient was a green consumer, so she may have been infected by consuming health foods. Sparganosis should be considered as a cause of soft tissue masses especially among patients who have ingested health foods.

Keyword

Sparganosis; Bartholin's gland abscess

MeSH Terms

Abscess
Animals
Cats
Cestoda
Dogs
Eating
Food, Organic
Humans
Life Cycle Stages
Mammals
Membranes
Mucus
Snakes
Sparganosis
Sparganum
Spirometra
Vulva

Figure

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  Fig. 1 CT showed nonenhancing multiple nodular lesions at right sided vulva. (A) Coronal view of vulva and perineum. (B) Sagittal view of vulva and perineum.

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  Fig. 2 Specimen showed a sparganum.

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  Fig. 3 There were pathologic findings. (A) Microscopic findings showed massive infiltration of acute and chronic inflammatory cells containing many eosinophils (H&E stain, ×100). (B) There were a few foreign body giant cells (H&E stain, ×100). (C) The organism was non-segmented and have thick eosinophilic tegmentum and irregularly scattered bundles of longitudinal muscle fibers (H&E stain ×20). (D) The high power view of muscle bundles showed reddish muscle fibers (Trichrome stain, ×200).

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  Fig. 4 There were translabial ultrasonographic finding during re-operation. (A) There was a nodule at right sided vulva. (B) There was Doppler finding a nodule at right sided vulva.

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  Fig. 5 There were re-operation finding. (A) There is re-operation site assisted by radiologist. (B) There was a removed remnant.

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