Authors’ response

Sir,

We thank Wiwanitkit1 for his observations on our clinical image2. Sparganosis is extremely rare in India3. In areas where the disease is highly endemic, sparganosis should also be considered in the differential diagnosis of subcutaneous swellings4. However, subcutaneous sparganosis is clinically indistinguishable from subcutaneous cysticercosis and histopathological confirmation is required for differentiating these conditions. In our patient, excision biopsy and histopathological examination confirmed the diagnosis. Pre-operative diagnosis of sparganosis is seldom made and the diagnosis of subcutaneous sparganosis becomes evident following surgical excision and histopathological examination. There is no effective medical treatment available for sparganosis and complete excision is curative4. External and internal autoinfections have also been hypothesized as possible mechanisms of causation of human cysticercosis. When hygienic standards are poor, hand washing after defecation and before eating food are not scrupulously followed, faecal-oral infection with Taenia solium eggs (external autoinfection) can occur in persons with intestinal taeniasis. In humans, the possibility of infection with Taenia solium eggs through reverse peristalisis (internal autoinfection) is considered to be controversial and merits further study5.