Shocking news! The neck lump is actually a 40cm long parasite infection! Beware of these symptoms

Recently, the General Surgery Department II of Xinning County People's Hospital admitted a patient with a neck lump. The patient was diagnosed with subcutaneous sparganosis after joint efforts from the Pathology Department and the Infectious Disease Department. After surgery and drug treatment, the patient recovered and was discharged from the hospital.

Brother Wen, 52 years old, found a lump on the right side of his neck half a year ago. At first, it was only the size of a thumb, and it was painless and it was not taken seriously. The lump gradually grew larger, and he felt uncomfortable after moving his neck. He visited several hospitals and all of them recommended surgery. On February 9, he was admitted to the Second Department of General Surgery of Xinning County People's Hospital with a "neck lump".

The attending doctor Liu An carefully examined the patient's neck mass, which was about 3*2cm in size and had no special appearance. After sufficient preparation, on February 10, deputy chief physician Guo Jinming and attending physician Liu An performed a mass removal surgery on Wen. During the operation, it was found that the local muscle of the mass was edematous. When the muscle was pulled apart, a white strip about 40cm long was found. The local edematous muscle was removed for biopsy, and the white strip was immediately sent to the pathology department for examination. The operation went smoothly.

▲The white strips of material taken out from the lump on Brother Wen’s neck - sparganosis

Director of the Pathology Department Yan Xueping carefully examined the specimen and asked about the patient's past experience. He considered that the white strip was sparganosis. The department immediately asked Director of the Infectious Diseases Department Tang Chengjian for consultation. Considering the patient's experience of eating uncooked food, he considered that the neck mass of Brother Wen was subcutaneous sparganosis.

Because the parasites and local edema muscles had been surgically removed, in order to prevent parasites from parasitizing other parts of the body, praziquantel was given, and a cranial MRI and ophthalmology consultation were completed to rule out eye and brain sparganosis. Liver and kidney function were monitored in a timely manner after medication. Brother Wen recovered well and was discharged from the hospital on February 15.

Medical Science - Sparganosis

Sparganosis is the larvae of Spirometra mansoni (a parasite). It is long and white, with a strong ability to stretch and contract. Its length ranges from 0.3 to 105 cm. It can parasitize in subcutaneous tissue, central nervous system, internal organs, eyes, oral cavity and muscles, causing sparganosis. In recent years, new cases have been reported all over the world.

1. Infection route

The tapeworm is widely distributed around the world, and the adult worms parasitize in the small intestine of carnivorous animals such as dogs, cats, and tigers. The larvae of the tapeworm mainly parasitize in the muscles and subcutaneous tissues of frogs, and can also parasitize in vertebrates such as snakes, birds, and pigs.

Humans can be infected by eating uncooked frogs, snakes, etc., or accidentally drinking water contaminated with sparganosis. In addition, applying raw frog skin and frog meat infected with sparganosis directly to skin ulcers or eye diseases is also a common route of infection.

2. Symptoms - subcutaneous nodules or lumps

Most commonly, patients may develop round, oval, cord-like or irregular subcutaneous nodules or lumps ranging in size from soybeans to walnuts under their skin. The lumps are mobile and cause local pain and itching.

3. Symptoms - eye inflammation-like reaction

Symptoms include red and swollen eyelids, conjunctival congestion and edema, photophobia, tearing, itching or a crawling sensation; bulging of the eyeball and eye movement disorders may occur; in severe cases, corneal ulcers may occur, and even cataracts may cause blindness. Clinically, it is often misdiagnosed as sty, acute uveitis, orbital cellulitis, tumors, etc., and is often diagnosed only after surgery.

4. Symptoms - Others

Symptoms that occur in the internal organs manifest as inflammation of the relevant parts and the appearance of corresponding symptoms. If the parasites parasitize in the brain, it can cause a series of symptoms such as vomiting, epilepsy, syncope, convulsions, etc., which can be easily misdiagnosed as brain tumors.

5. Treatment

Migratory rash or mass is of great value for diagnosis. Subcutaneous sparganosis is mainly removed surgically. It is necessary to remove all the worms, especially the head, to cure it. 2-4 ml of 40% alcohol procaine can also be injected locally to kill the worms. Drug treatment can use albendazole, compound mebendazole, praziquantel, etc. Surgery and drug combination treatment can also be used, and individualized treatment plans are determined according to the site of infection. Timely regular treatment generally has a good prognosis and will not leave serious complications.

6. How to prevent

① Avoid eating uncooked frog meat, snake meat, bird meat, pork, etc. Do not drink raw water or water contaminated by sparganosis.

② Avoid using raw frog skin and frog meat to treat skin and eye diseases, to prevent parasites from entering the body through skin wounds or mucous membranes;

③. Use separate knives and chopping boards for cutting raw and cooked meat;

④. If you have a pet, deworm it in time;

⑤. Pay attention to hygiene, wash your hands frequently, and exercise appropriately to enhance immunity;

⑥ Relevant departments shall strengthen animal quarantine supervision, livestock slaughter management and meat inspection, and ensure the harmless disposal of sick animals.

Hunan Medical Chat Special Author: Liu An and Tang Chengjian from Xinning County People's Hospital

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(Edited by Wx)