GnathostomiasisB83.1

Human infection by the nematode (roundworm) Gnathostoma spinigerum and/or Gnathostoma hispidum. The intermediate host of the nematodes is a cancer that is eaten by other intermediate hosts such as frogs, reptiles, birds or small mammals. Final hosts are cats or dogs. Man is a false host.

Endemic areas are mainly in South East Asia, especially Thailand and Vietnam, in Central America Mexico is mainly affected. In Europe only immigrants and tourists are affected.

A few days after consumption of e.g. raw fish (e.g.: sushi) or raw frog meat, nausea, gastrointestinal pain or fever occurs, caused by the migration of the larvae through the intestinal wall. Migration into the subcutis causes intermittent, painful or itchy, reddened subcutaneous swellings (DD: angioedema). The swellings usually persist for several days, but may last up to 4 weeks. The recurrent course of the symptoms is typical. The pathogens can also migrate to other organs (visceral larva migrans), e.g. lungs (persistent cough), muscles (muscle pain), urinary tract organs(haematuria), eye or meninges (meningitis). Eosinophilia of the blood is common.

Larvae are usually not detectable. Detection of antibodies (ELISA) against G. spinigerum (e.g. by special laboratory of the Robert Koch Institute [RKI]). blood eosinophilia.

1. Leroy J et al (2017) Sushi, ceviche and gnathostomiasis - A case report and review of imported infections.Travel Med Infect Dis 20:26-30.
2. Pönninghaus J (2010) Gnathostomiasis. In: Plettenberg A, Meigel W, Schöfer H Infectious diseases of the skin. Thieme publishing house Stuttgart S. 421-422