title: Sparganosis presenting as cauda equina syndrome with molecular identification of the parasite in tissue sections.
abstract: A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.
authors: Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors: Adhiratha
authors: A
authors: Boonyasiri
authors: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors: Pornsuk
authors: P
authors: Cheunsuchon
authors: Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors: Prajak
authors: P
authors: Srirabheebhat
authors: Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Yamasaki
authors: Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. ; Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
authors: Wanchai
authors: W
authors: Maleewong
authors: Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. ; Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
authors: Pewpan M
authors: PM
authors: Intapan
mesh_terms: D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D003576:Electron Transport Complex IV / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015801:Helminth Proteins / Q000235:genetics; D006651:Histocytochemistry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D008969:Molecular Sequence Data; D011128:Polyradiculopathy / Q000473:pathology*; D011859:Radiography; D017422:Sequence Analysis, DNA; D013031:Sparganosis / Q000175:diagnosis* / Q000473:pathology*; D013131:Spine / Q000000981:diagnostic imaging; D013146:Spirometra / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000909:Antibodies, Helminth; D015801:Helminth Proteins; D007074:Immunoglobulin G; D003576:Electron Transport Complex IV
keywords: Spirometra erinaceieuropaei; cauda equina syndrome; molecular identification; sparganosis