Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant

Dennis Tappe Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Luise Berger Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Alexandra Haeupler Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Birgit Muntau Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Paul Racz Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Yves Harder Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Katja Specht Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Clarissa Prazeres da Costa Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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Sven Poppert Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Institute of Pathology, Technische Universität München, Munich, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany

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We report a case of subcutaneous sparganosis in a 68-year-old female Japanese immigrant in Germany. The patient complained of a painless erythema caudal of the umbilicus with a palpable subcutaneous cherry-sized lump. Polymerase chain reaction on formalin-fixed parasite tissue identified Spirometra erinaceieuropaei as the causative agent; the proliferative form of sparganosis, which is caused by the branching and disseminating Sparganum proliferum, could, thus, be excluded. From the excised sparganum, an immunofluorescence test was established and revealed an antibody response directed against the parasite's tegument. Histological key features of the plerocercoid that facilitate diagnosis with different stains are presented.

Author Notes

* Address correspondence to Dennis Tappe, Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. E-mail: dtappe@hygiene.uni-wuerzburg.de

Authors' addresses: Dennis Tappe, Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany, E-mail: dtappe@hygiene.uni-wuerzburg.de. Luise Berger and Yves Harder, Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, E-mails: Luise.Berger@lrz.tu-muenchen.de and Harder@lrz.tu-muenchen.de. Alexandra Haeupler and Paul Racz, Department of Pathology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, E-mails: haeupler@bni-hamburg.de and racz@bni-hamburg.de. Birgit Muntau and Sven Poppert, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, E-mails: muntau@bni-hamburg.de and poppert@bni-hamburg.de. Katja Specht, Institute of Pathology, Technische Universität München, Munich, Germany, E-mail: specht@lrz.tum.de. Clarissa Prazeres da Costa, Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Munich, Germany, E-mail: clarissa.dacosta@mikrobio.med.tum.de.

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