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Two cases of human infection by adult of Spirometra erinacei
Soon Hyung Lee,Jong-Yil Chai,Byong-Seol Seo and Seung-Yull Cho
Department of Parasitology and Institute of Endemic Diseases, College of Medicine, Seoul National University, Korea.
Department of Parasitology, College of Medicine, Chung-Ang University, Korea.
Abstract
Two cases of human infection by adult Spirometra erinacei were proved by collection of worms in Korea. The patients were 24 and 21-year old males residing in a mountainous village in Kangwon-do. They had the clinical complaints of abdominal pain and epigastric discomfort, revealing the diphyllobothriid eggs, 53~59 × 37~42 µm in size, in their stools. They were treated with 500 mg atabrine and purgated with magnesium salts, and 3~4 hours later several chains of tapeworm segments were recovered from the diarrheal stools. The recovered worms revealed the morphological characteristics of spiral-form or coiled uteri, separated vaginal opening from the cirrus sac, incorporated seminal vesicle into the cirrus sac, distribution of testes at the junction between proglottids, asymmetrical eggs with one pointed eggs, etc. and were identified as Spirometra erinacei(Rudolphi, 1819). The cases had the history of eating raw flesh of the snakes and these are considered the source of infection.
Fig. 3. Seven proglottides of S. erinacei from Case 1. Whole mount. Note the cirrus sac at anteromedian protion of each proglottid and spiral or coiled shape of uteri. x8.
Fig. 4. Five progolttides from Case 2. The number of uterine coils is 3 in each proglottid. x8.
Fig. 5. Magnification of two progolttides from Case 1. Whole mount. Note the cirrus sac with cirrus opening (large arrow) and vaginal opening (small arrow) beneath. x60.
Fig. 6. Magnification of anteromedian portion of a proglottid os S. erinacei from Case 2. Whole mount. The cirrus (CO) and vaginal (VO) openings are separated and the uterine opening (UO) is seen beneath them. x120.
Fig. 7. Lonitudinal section showing uninterrupted testes (T) between two proglottides from Case 1. Note the superficially distribution vitelline follicles (arrows). H-E stain. x120.
Fig. 8. Longitudinal section at middle portion of a proglottid from Case 1. Note the separated cirrus and vaginal openings (VO) and uterus(Ut) with many eggs are seen. H-E stain. x120.
Fig. 9. An intrauterine egg is S. erinacei from Case 2. It is asymmetrical in shape with a little pointed anterior end.
Fig. 10. Another egg of S. erinacei from stool of Case 1. Note asymmetrical shape with one pointed end and apical knob.
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