The incidence of
sparganosis, a
parasitic disease caused by plerocercoid larvae of the genus Spirometra, has gradually risen worldwide (especially in remote areas) in recent years. Pulmonary and pleural
sparganosis, as well as other sites of infestation, including the subcutaneous tissues, the abdominal viscera, brain and eyes, has been reported. In clinical practice, due to the atypical signs and symptoms as well as limited laboratory approaches for the specific detection of sparganum,
sparganosis is often misdiagnosed. In the present study, an 11-year-old girl visited the Department of
Infectious Diseases in Shanghai Children's Medical Center for recurrent shoulder and
chest pain and
shortness of breath. Imaging tests demonstrated bilateral pleural and
pericardial effusion, enlarged lymph nodes in front of the tracheal carina, and
infection of the left lower lobe. Sparganum were not observed in the dissected soft tissue at the root of the right thigh with naked-eye and light microscopy examination. Histologic examination revealed granulomatous
inflammation and tunnel-like
necrosis with eosinophilic, neutrophilic and lymphocytic infiltration. Although the patient's serum was positive for sparganum
antibodies, the diagnosis of
sparganosis was not confirmed for more than three months. Ultimately, genomic
DNA of Spirometra erinaceieuropaei was detected in the mass at the root of the right thigh using next-generation sequencing (NGS), confirming the diagnosis of
sparganosis. The patient was treated with
praziquantel (150 mg/kg/day) without recurrence after an eight-month follow-up. We present, for the first time, a study of human
sparganosis diagnosed using NGS, which provided a clinically actionable diagnosis of a specific
infectious disease from an uncommon pathogen.