A Case of Intra-orbital Sparganosis

ABSTRACT

The orbitll sparganosis is an extremely rare disease which clinical signes were similar to orbital-cellulitia. Authors reported a case of sparganosis which a 59 years old Korean man complained swellina of lid, chemosis and dull ocular pain in the right eye for 5 months. On eye examination, the visual acuity was 0.5 in the right eye and 0.8 in the left which was incorrectable because of bilateral senile cataract. The left eye had no other anomalities. The right eye was markedly chemotic and restricted ocular motility in the 6 cardinal directions but no exophthalmos. There was a soft elevated and mobile nodule subconjunctivally on the upper portion of the globe and the other nodule was palpated along lower orbital margin. Roentgenologic findings showed diffuse increased radiopaque density but no bony changes in the orbit. Chest and skull x-ray were normal. In the laboratory findings, eosinophilia showed in CBC, hookworm, trichuris T., and T. orientalis in stool examination and positive skin test in Paragonimus westermani and Clonorchis sinensis. On the 3rd, Sep., 1971, we found 4 spargana on surgical exploration of which sizes were approximately 8.5, 9.5, 5.0, and 3.6 cm. in length. A sparganum in upper portion freely stirred sluggishIy in the subconjunctiva but the other 3 in the lower orbital portion were found in the seperated long cysts. The cystic tissue showed nonspecific chronic inflammatory reaction in pathological examination. The infected source was suggested to a history of having taken raw flesh of snake about 30 years ago. Orbital signs were much regressed 15 days later after operation.