Human Sparganosis in Korea

Abstract

Background: Sparganosis is a larval cestodiasis caused by the plerocercoid of Spirometra spp. Since the first description of human sparganosis in 1924, several hundred cases have been reported in Korea. However, systematic approaches for literature surveys of Korean sparganosis have seldom appeared.

Methods: We searched publicly available databases such as PubMed, Research Information Sharing Service, and Korea Medical Citation Index with relevant Medical Subject Headings.

Results: At least 438 Korean sparganosis cases have been described from 1924 to 2015. Preoperative diagnosis has been significantly increased since the 1980s due to popularization of serological and imaging diagnostics. Cases were largely detected from fifth decades in general, but cerebral sparganosis was detected in relatively young age groups (third and fourth decades). Sparganosis was prevalent in men (75.9%). Consumption of frog/snake and drinking unfiltered water were found in 63.4% and 16.9% of patients, respectively. Most frequently affected sites were subcutaneous tissues (49.9%), followed by the central nervous system (36.2%). Involvements of visceral organs (7.6%), ocular regions (3.6%), and muscles (2.7%) were noticed. In women, breast sparganosis constituted a large proportion (34.2%). Sparganosis associated with immunocompromised patients has recently been reported.

Conclusion: Sparganosis has been continuously reported in Korea during the past 90 years, although its incidence has decreased during the last 20 years. The disease is mostly characterized by subcutaneous nodule, but infection of the worm in vital organs often results in serious illness. Continuous awareness is warranted to monitor sparganosis occurrence and associated clinical consequences.

Keywords: Central Nervous System; Immunocompromised Patient; Korea; Sparganosis; Sparganum; Subcutaneous Tissue.

Fig. 1. Decennial distribution patterns of human sparganosis reported in Korea during 1924–2015. At least 438 sparganosis cases were reported in Korea. Cases reported between 1924 and 1953 referred to cases recorded in Korean peninsula and those after 1954 represented sparganosis reported in the Republic of Korea. Duplicated publications were excluded by reviewing individual papers.

^aMost medical records in Korea were not preserved during 1944–1953 due to the Pacific War (1941–1945), post-war chaos (1945–1948) and the Korean War (1950–1953).

Fig. 2. Age and sex distribution of sparganosis cases in Korea. Among 438 cases, 284 patients were men and 114 patients were women. We could not trace personal information for 40 cases.

Fig. 3. Number and sex distribution of cases according to infection sites.

CNS = central nervous system. ^aCNS sparganosis included spinal cord infection; ^bTotal number of cases exceeded 438 due to infections at multiple sites in 7 cases (4 cases of subcutaneous and muscular infections, 2 cases with subcutaneous and visceral infections, and 1 case of systemic sparganosis).

Fig. 4. Age and sex distribution of patients with cerebral sparganosis whose demographic information is available (n = 116).