Subcutaneous larva migrans of a sparganum in a gnathostomiasis-endemic area

We report a case of subcutaneous larva migrans caused by a tape worm (sparganum), a rare and under-recognized food-borne parasitic zoonosis, in Nan Province, Northern Thailand. An obese 56-year-old female presented a 3-month history of an intermittent migrating subcutaneous nodule in the abdomen associated with pain and itching. Physical examination showed a tubal resection scar on the lower abdomen with a swelling and movable irregular, and firm nodule with ill-defined border at the right lower quadrant of abdomen. Blood examination showed slight increased of eosinophil levels (6%). Excisional biopsy showed a viable non-segmented tape worm in the subcutaneous tissue identified by morphological examination and Western blot technique as a sparganum. Surgical removal is recommended for a worm in the subcutaneous connective tissues and superficial muscles.