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      Case report: the first case of human infection by adult of SPIROMETRA ERINACEIEUROPAEI in VIETNAM

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          Tapeworms of the genus Spirometra include species whose larval stages can infect humans, causing a disease called sparganosis. Cases of human infection with adult worms are very rare and have been reported in Korea and China. Here we report the first case of human infection with an adult of Spirometra erinaceieuropaei in Vietnam.

          Case presentation

          A 23-year-old male was admitted to 103 Military Hospital, Hanoi, Vietnam with fever, weight loss and epigastric discomfort. Preliminary diagnosis based on discovery of parasite eggs in his faeces incorrectly determined a fluke as the agent of the infection and praziquantel was prescribed. Two days later he passed out proglottids in his stool. The tapeworm was identified as Spirometra erinaceieuropaei using morphological and molecular tools.


          This is the first case of human infection with adult worm of Spirometra erinaceieuropaei in Vietnam.

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          Most cited references 11

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          Human Infections with Spirometra decipiens Plerocercoids Identified by Morphologic and Genetic Analyses in Korea

          Tapeworms of the genus Spirometra are pseudophyllidean cestodes endemic in Korea. At present, it is unclear which Spirometra species are responsible for causing human infections, and little information is available on the epidemiological profiles of Spirometra species infecting humans in Korea. Between 1979 and 2009, a total of 50 spargana from human patients and 2 adult specimens obtained from experimentally infected carnivorous animals were analyzed according to genetic and taxonomic criteria and classified as Spirometra erinaceieuropaei or Spirometra decipiens depending on the morphology. Morphologically, S. erinaceieuropaei and S. decipiens are different in that the spirally coiled uterus in S. erinaceieuropaei has 5-7 complete coils, while in S. decipiens it has only 4.5 coils. In addition, there is a 9.3% (146/1,566) sequence different between S. erinaceieuropaei and S. decipiens in the cox1 gene. Partial cox1 sequences (390 bp) from 35 Korean isolates showed 99.4% (388/390) similarity with the reference sequence of S. erinaceieuropaei from Korea (G1724; GenBank KJ599680) and an additional 15 Korean isolates revealed 99.2% (387/390) similarity with the reference sequences of S. decipiens from Korea (G1657; GenBank KJ599679). Based on morphologic and molecular databases, the estimated population ratio of S. erinaceieuropaei to S. decipiens was 35: 15. Our results indicate that both S. erinaceieuropaei and S. decipiens found in Korea infect humans, with S. erinaceieuropaei being 2 times more prevalent than S. decipiens. This study is the first to report human sparganosis caused by S. decipiens in humans in Korea.
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            Suppression of the tapeworm order Pseudophyllidea (Platyhelminthes: Eucestoda) and the proposal of two new orders, Bothriocephalidea and Diphyllobothriidea.

            Pseudophyllidea van Beneden in Carus, 1863, a well recognised order of tapeworms (Platyhelminthes: Eucestoda), is suppressed because it is composed of two phylogenetically unrelated groups, for which the new names Bothriocephalidea and Diphyllobothriidea are proposed. The new orders differ from each other in the following characters: (i) position of the genital pore: on the dorsal, dorso-lateral or lateral aspects and posterior to the ventral uterine pore in the Bothriocephalidea versus on the ventral aspect of segments and anterior to the uterine pore in the Diphyllobothriidea; (ii) the presence of a muscular external seminal vesicle in the Diphyllobothriidea, which is absent in the Bothriocephalidea; (iii) the presence of a uterine sac in the Bothriocephalidea, which is absent in the Diphyllobothriidea; and (iv) the spectrum of definitive hosts: mainly teleost fishes, never homoiothermic vertebrates in the Bothriocephalidea, versus tetrapods, most frequently mammals, in the Diphyllobothriidea, with species of Diphyllobothrium, Spirometra and Diplogonoporus parasitic in humans. The Diphyllobothriidea, which includes 17 genera in four families (Digramma is synonymised with Ligula), is associated with cestode groups that have a range of plesiomorphic characters (Haplobothriidea and Caryophyllidea), whereas the Bothriocephalidea, consisting of 41 genera grouped in four families, is the sister-group to the 'acetabulate' or 'tetrafossate' cestodes, which are generally regarded as having derived characters.
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              Two cases of human infection by adult of Spirometra erinacei


                Author and article information

                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                10 October 2017
                10 October 2017
                : 17
                [1 ]Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam
                [2 ]Department of Infectious Disease, 103 Military Hospital, VMMU, Hanoi, Vietnam
                [3 ]GRID grid.452658.8, Department of Molecular Biology, , National Institute of Malariology, Parasitology and Entomology (NIMPE), ; Luong The Vinh Street, Hanoi, Vietnam
                [4 ]GRID grid.452658.8, Department of Molecular Biology, , National Institute of Malaria, Parasitology and Entomology (NIMPE), ; Hanoi, Vietnam
                [5 ]Department of Parasitology, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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