A waterborn zoonotic helminthiase in an Italian diver: a case report of a cutaneous Sparganum infection and a review of European cases

Abstract

Many waterborne helminthes are opportunistic parasites that can travel directly from animals to man and may contain forms capable of penetrating the skin. Among these, Sparganum is the pseudophyllidean tapeworm that belongs to the genus Spirometra, which is responsible for parasitic zoonosis; it is rarely detected in Europe and is caused by the plerocercoid infective larva. Thus far, only six cases of cutaneous and ocular sparganosis have been reported in Europe; two and four cases have occurred in France and Italy, respectively. Herein, we describe a new case of sparganosis in Italy that affected a male diver who presented to the Bambino Gesù Children's Hospital of Rome. The patient's skin biopsy was submitted to the Parasitology department who, in consultation with Pathology, concluded that the morphologic and microscopic findings were those of Sparganum spp. larvae. The patient recovered following a single dose of 600 mg praziquantel.

Keywords: Cutaneous infection; Diver; Europe; Spirometra; Waterborne zoonotic helminthes Sparganum.

Figure 1

A Papulopustular lesions within an erythematous plaque of about 2 cm on the left elbow; B After 1 month, growth of the plaque and erosions due to evolution of the pustular lesions are reported; C Inflammatory granulomatous dermal/subdermal process, haematoxylin and eosin (EE) staining, 40x; D After 3 months, almost complete healing of the lesion with mild residual erythema. Redness disappeared several weeks later.

Figure 2

A Section of Sparganum spp. larva, EE staining, 10×; B Excretory pores in Sparganum spp. section, PAS staining, 63×; C Sparganum spp. cycle.