Sparganum in the Lumbosacral Canal: a Case Report

Background: Sparganosis is a rare parasitic infection caused by invasion of the larvae of tapeworms Spirometra mansoni called sparganum. It often lodges in human eyes, subcutaneous body of limbs, oral and maxillofacial regions. However, lumbosacral spinal canal invasion is extremely rare and the diagnosis is very difficult. We herein report a case of spinal sparganosis.Case presentation: A 56-year-old man presented at the hospital after having experienced perianal pain for a week. MRI of the lumbosacral spine with gadolinium contrast study revealed an enhancing mass at the S1-S2 level that was clinically suggestive of a tumor. The patient underwent laminectomy from S1 to S2. We detected a live worm in inferior margin of L5 and spinal sparganosis was diagnosed by histological examination. He had a history of ingesting undercooked frog meat in his youth. Both in CSF and serum samples, we detected anti-sparganum antibodies. A dose of praziquantel, albendazole and dexamethasone was administered to the patient because we did not remove the parasitic mass completely.Conclusions: Sparganosis of the central nervous system is extremely rare, especially spinal sparganosis. The mainly treatments spinal sparganosis are surgical removal of the larva and administration of high-dose praziquantel, albendazole and dexamethasone.

Reducing Results Variance in Lifespan Machines: An Analysis of the Influence of Vibrotaxis on Wild-Type Caenorhabditis elegans for the Death Criterion

Nowadays, various artificial vision-based machines automate the lifespan assays of C. elegans. These automated machines present wider variability in results than manual assays because in the latter worms can be poked one by one to determine whether they are alive or not. Lifespan machines normally use a “dead or alive criterion” based on nematode position or pose changes, without poking worms. However, worms barely move on their last days of life, even though they are still alive. Therefore, a long monitoring period is necessary to observe motility in order to guarantee worms are actually dead, or a stimulus to prompt worm movement is required to reduce the lifespan variability measure. Here, a new automated vibrotaxis-based method for lifespan machines is proposed as a solution to prompt a motion response in all worms cultured on standard Petri plates in order to better distinguish between live and dead individuals. This simple automated method allows the stimulation of all animals through the whole plate at the same time and intensity, increasing the experiment throughput. The experimental results exhibited improved live-worm detection using this method, and most live nematodes (>93%) reacted to the vibration stimulus. This method increased machine sensitivity by decreasing results variance by approximately one half (from ±1 individual error per plate to ±0.6) and error in lifespan curve was reduced as well (from 2.6% to 1.2%).

Ocular Dirofilariasis after Clinically Manifested Subcutaneous Migration of the Parasite: A Case Report

Dirofilaria repens is the causative agent of human subcutaneous or, less often, ocular dirofilariasis. The work presents a rare case of ocular dirofilariasis manifested by previous subcutaneous migration accompanied by severe headache symptoms. In February 2017, a 58-yr-old man from Trnava region, western Slovakia, noticed red and itchy stripes on his left leg. Inflamed but painless stripes disappeared and showed up again every 5–7 days, migrating gradually towards the head. Approximately one month after the first skin´s alterations, strong pain in the left temple, with the swelling of the left face and the enlargement of mandibular lymph nodes appeared. Several days later, the patient felt excruciating pain of the right eyeball accompanied by strong nausea and subsequent vomiting. Ocular examination revealed the presence of a live worm in the subconjunctival space and morphological and molecular analyses of extracted helminth confirmed D. repens as etiological agent of the infection. According to clinical manifestation of the infection, it could be supposed that ocular form of the disease was the result of the migration of a parasite through the subcutaneous tissues. Moreover, a rare phenomenon of lymphadenitis of underlying lymph nodes and the swelling of left face accompanied the migration.

Confrontation with a live subretinal parasite

Background: Parasitic infestation of the eyes are a major cause of ocular diseases across the globe. Filarial and filarial-like nematodes top the list of the nematodes that affect the eye. Case: A rare case of live sub retinal worm is reported in a 25 years old apparently healthy young male. The case presented with unilateral loss of vision and floaters in the affected eye. Upon examination a live subfoveal worm was identified with continuous wriggling movements and diffuse retinal edema. The worm was removed surgically and sent for parasitological examination. Observation: The worm was identified microscopically as Loa Loa. However detailed histopathological examination could not be incorporated. The patient’s vision improved to 6/12 (0.30 Log MAR) from the initial presentation of 3/60 (1.30 Log MAR) after three months follow-up. Conclusion: The rare sub retinal live worm presents a challenge in management. The management depends upon the location and viability of the parasite. Surgical management is aimed at worm removal and vision preservation.

Enterobius vermicularis in anterior chamber of eye

Enterobius vermiculari which is often referred as pinworm, is an intestinal nematode which is transmitted through fecal-oral route. The extraintestinal presentation of the worm is rare. A live worm, Enterobius vermicularis in anterior chamber is a very rare case. To present an unusual case of Enterobius vermicularis in anterior chamber of right eye in a 3 years old girl. Visual acuity assessment, slit lamp examination and ultrasonography of the eye were performed. The worm was found in anterior chamber of right eye at 8-9 o' clock hour position, coiling at the presentation. The living, white worm was freely moving and changing position frequently. There was hypopyon with exudates inferiorly. The pupil was irregular, posterior synechiae was present with cataractous lens. The living worm was removed surgically under general anesthesia and sent for microbiological examination. Synecholysis with lens aspiration and Posterior chamber intraocular lens implantation was done in second surgery. An adult worm in anterior chamber is rare. Treatment is surgical removal. The visual prognosis is not good when the case present with severe form of anterior uveitis and complicated cataract.

Determinants and outcome of periocular dirofilariasis in a cohort of patients with demonstrable live worm from the ocular and adnexal parasitic granulomas

Purpose: We attempt to describe the unique diagnostic features of dirofilariasis affecting the eye, a rare disease caused by the nematode dirofilaria repens. Case report: The cohort includes 5 adult cases of ocular dirofilariasis. Migratory oedema was present in all but one case. The occurrence of the lesions near the medial canthus in all the cases including subconjunctival mass suggests predictable pattern of migration of the worm. Absence of systemic eosinophila and lack of marked eosinophilic infiltration around the parasitic granuloma in histopathology indicates alternative immune response against the parasite. Persistence of live worm despite antihelminthic drugs can be accounted by the presence of a thick capsule which protects the filaria against adulticidal and larvicidal drugs. Surgical exicision was curative in all cases.Conclusion: Our case series points to the importance of having high index of suspicion and early detection of ocular dirofilariasis as it is amenable to simple and effective treatment.

Beware of Foreign Body Sensation” This Live Worm can Swim Through Your Eye! - A Case Series on Increasing Prevalance of Ocular Dirofilariasis in Tropical India: A Disease of Travel to Foreign Lands

The purpose is to report a case series of increasing prevalence of ocular Dirofilariasis in tropical areas of South India and the importance of the disease with travel to tropical areas Human Dirofilariasis, caused by Dirofilaria repens, have been reported to occur widely throughout Asia, Europe, and Africa. The Dirofilaria are natural parasites of mammals and are transmitted to man by zooanthrophilic mosquitoes. It is emphasized that both clinicians and microbiologists should have an increased awareness of this entity and include dirofilariasis in the differential diagnosis of patients presenting with subcutaneous nodules. Excision of the lesion is both diagnostic and therapeutic.