Clinical features and global epidemiological analysis of sparganosis: based on 5 pediatric cases and a systematic review of 135 literature reports

Objective Sparganosis is a rare parasitic disease caused by the larvae of Spirometra mansoni, with pediatric cases being particularly uncommon and prone to misdiagnosis. This study aims to analyze the clinical features, diagnostic strategies, and treatment responses in pediatric sparganosis, and to investigate its global epidemiological trends and diagnostic and therapeutic advancements through a systematic review. Methods We conducted a retrospective analysis of 5 confirmed pediatric sparganosis cases admitted to our center between 2014 and 2023. A systematic search of the PubMed database (1980–2025) for relevant literature was performed, leading to the screening and data extraction of 135 global case reports. Descriptive statistics, correlation analysis, and trend visualization were conducted using R software (version 4.5.1). Results Among the 5 children in our center, the median age was 7 years, and all were from high-parasitic-endemicity areas in Yunnan Province, China. All cases (100%) presented with marked eosinophilia (median value 4.42 × 10⁹/L). Neurological involvement was predominant (60%, 3/5), manifesting as epilepsy, myelitis, etc. All patients received praziquantel treatment, with four also receiving concomitant corticosteroids, and all showed symptom improvement. Analysis of global cases revealed a geographic clustering in East Asia (primarily China, South Korea, Japan, and Thailand), with the central nervous system and subcutaneous tissue being the two major infection sites. Diagnosis relied mainly on MRI (“tunnel sign”), serological testing, and metagenomic Next-Generation Sequencing (mNGS). The highest improvement rate (92.2%) was observed with combination therapy (surgery plus medication), which yielded comparably high improvement rates to single-modality treatments. Conclusion Pediatric sparganosis predominantly involves the nervous system. Diagnosis requires integrating epidemiological history, imaging, and molecular testing. Treatment should be individualized, with a recommended regimen of surgery combined with long-term, weight-based praziquantel therapy, supplemented by corticosteroids when necessary. Strengthening public health education remains the fundamental measure for preventing this disease.