Radiologic identification of dracunculiasis in a nonendemic region: A case report

Dracunculiasis (Guinea worm disease) is a parasitic infection caused by Dracunculus medinensis, now nearing global eradication. We report a rare case from a nonendemic region involving a 75-year-old woman with a 10-day history of dull, radiating left hip pain and intermittent discomfort for 2 months. Examination revealed localized tenderness, mild muscle weakness, and restricted hip mobility. Laboratory results were normal. Pelvic radiography and computed tomography demonstrated dense, serpentine intramuscular calcifications along the left adductor muscles, highly suggestive of a calcified D. medinensis. Given the patient's clinical history, imaging findings, and regional rarity of the disease, a presumptive diagnosis was made without histological confirmation. The patient improved with physiotherapy and declined surgery. This case highlights the need to consider parasitic infections in the differential diagnosis of intramuscular calcifications, even in countries where the disease is considered eradicated, to avoid misdiagnosis and unnecessary interventions.