After ingestion, larvae migrate through the intestinal wall to distant sites, mostly the skin and skeletal muscle, where they are unable to undergo further development (Kron et al., 1991). Thus, the disease presents as a slowly growing subcutaneous mass, commonly diagnosed after excisional biopsy. Other sites involved include the periorbital tissue, genitourinary system and

Fig. 19c.8 Pleocercoid larva of Sparganum mansoni excised from an adult patient with migratory swelling

abdominal viscera. Central nervous system infection is very uncommon but the consequences are much more severe than other forms of the disease. Seizures are the most common clinical symptoms, associated with motor weakness and altered mental status in a minority of cases. The condition is chronic, with presentation occurring between 2 weeks and 24 years after infection. A satisfactory history of exposure to intermediate hosts can usually be obtained.

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