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Characterization of Calcification Events Using Live Optical and Electron Microscopy Techniques in a Marine Tubeworm

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Guinea Worm Disease Presenting as a Subcutaneous Calcification.

Virendra Athavale¹, Guneet Singh¹, Siddharth Tiwari²

¹General Surgery, Dr DY Patil Medical College and Hospital, Pune, IND.

|July 22, 2024

Summary

Multiple right thigh swellings in a Maharashtra woman were diagnosed as guinea worm disease after eight years. This case highlights an unusual presentation of the parasitic infection, emphasizing the need for accurate diagnosis in endemic rural areas.

Keywords:

calcifications calcified subcutaneous mass dracunculiasis guinea worm keloid

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Area of Science:

Tropical medicine
Parasitology
Dermatology

Background:

Guinea worm disease (Dracunculiasis) is a parasitic infection caused by Dracunculus medinensis.
It is typically acquired by drinking contaminated water containing cyclops water fleas.
Eradication efforts have significantly reduced its incidence globally.

Observation:

A female patient presented with chronic, multiple right thigh swellings over eight years.
The patient resided in a rural area of Maharashtra, a region historically associated with guinea worm disease.
Initial radiological investigations revealed only subcutaneous calcifications, lacking definitive signs of active infection.

Findings:

Surgical excision of the swellings revealed a worm-like morphology.
Histopathological examination confirmed the presence of guinea worms, diagnosing Dracunculiasis.
The presentation was atypical, with long-standing swellings and calcifications rather than the typical emergent worm.

Implications:

This case underscores the importance of considering guinea worm disease even with unusual clinical presentations, especially in endemic regions.
Accurate diagnosis through histopathology is crucial when radiological findings are inconclusive.
Awareness among surgeons is vital for effective management and potential identification of overlooked cases.