Case Report: Ocular Gnathostomiasis in Venezuela Most Likely Acquired in Texas.

A 69-year-old male dentist in Caracas, Venezuela, was referred to our Cornea Clinic with a history of pain, photophobia, and blurred vision on his left eye. Routine biomicroscopic examination with a slit lamp showed a worm in the corneal stroma of his left eye. The worm was surgically removed and was identified morphologically as Gnathostoma binucleatum.

Characterization of the humoral immune response against Gnathostoma binucleatum in patients clinically diagnosed with gnathostomiasis.

Gnathostomiasis is an emerging systemic parasitic disease acquired by consuming raw or uncooked fresh-water fish infected with the advanced third-stage larvae of Gnathostoma spp. This disease is endemic to the Pacific region of Mexico, and one of its etiologic agents has been identified as Gnathostoma binucleatum. We characterized the humoral immune response of patients clinically diagnosed with gnathostomiasis by detecting total IgM, IgE, and IgG class and subclasses against a crude extract of the parasite by Western blotting. Our results do not show differences in the antigens recognized by IgM and IgE. However, we found that the specific humoral immune response is caused mainly by IgG, specifically IgG4. We found that 43%, 65.2%, 54.1%, and 26.3% of the patients recognize the 37-kD, 33-kD, 31-kD, and 24-kDa antigens, suggesting that the 33-kD antigen is the immunodominant antigen of G. binucleatum.

Intraocular gnathostomiasis: report of a case and review of literature.

Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.

The Jeju weasel, Mustela sibilica quelpartis, a new definitive host for Gnathostoma nipponicum Yamaguti, 1941.

Adult gnathostomes were discovered in the stomach of the Jeju weasel, Mustela sibilica quelpartis, road-killed in Jeju-do (Province). Their morphological characters were examined to identify the species. Total 50 gnathostome adults were collected from 6 out of 10 weasels examined. In infected weasels, 4-6 worms were grouped and embedded in each granulomatous gastric tumor, except 1 weasel. Male worms were 25.0×1.4 mm in average size, and had a tail with pedunculate papillae, a spicule, and minute tegumental spines. Females were 40.0×2.5 mm in average size, and had a tail without tegumental spines. Pointed and posteriorly curved hooklets were arranged in 8-10 rows on the head bulb. Tegumental spines were distributed from behind the head bulb to the middle portion of the body. The spines were different in size and shape by the distribution level of the body surface. Fertilized eggs were 65.5×38.9 µm in average size, and had a mucoid plug at 1 pole. These gnathostomes from Jeju weasels were identified as Gnathostoma nipponicum Yamaguti, 1941. By the present study, it was confirmed for the first time that G. nipponicum is distributed in Jeju-do, the Republic of Korea, and the Jeju weasel, M. sibilica quelpartis, plays a crucial role for its definitive host.

Identification of estuarine fish Dormitator latifrons as an intermediate host and Eleotris picta as a paratenic host for Gnathostoma binucleatum in Sinaloa, Mexico.

Gnathostomosis is a typical fish-borne zoonotic parasitosis and is currently a serious public health issue in Mexico. Among several Gnathostoma species present in wild animals in Mexico, Gnathostoma binucleatum is the only proven species responsible for human diseases, and the advanced third stage larvae (AL3) of G. binucleatum have been found in over 20 species of fish in this country. In Sinaloa State, two fish species, Dormitator latifrons and Eleotris picta, were heavily contaminated with G. binucleatum AL3. When we analyzed the relationship between the size of the fish and the density of infection with G. binucleatum AL3, the distribution patterns of AL3 were markedly different between these two fish species. Apparent size-dependent accumulation was observed in E. picta but not in D. latifrons, suggesting that E. picta is a paratenic host whereas D. latifrons is a second intermediate host.

Larval Gnathostoma hispidum detected in the red banded odd-tooth snake, Dinodon rufozonatum rufozonatum, from China.

A total of 205 larval gnathostomes were collected from 18 (22.5%) of 80 red banded odd-tooth snakes, Dinodon rufozonatum rufozonatum, which had been smuggled from China and confiscated at Customs in Busan, Republic of Korea. In order to identify the species, some of the larvae were observed by a light microscope and a scanning electron microscope (SEM). The larvae were 2.18 x 0.29 mm in average size, and had a pair of lips at the anterior end, a muscular esophagus, 2 pairs of cervical sacs, and brownish intestines. The head bulb was characteristically equipped with 4 rows of hooklets; the average number of hooklets in each respective row was 38.6, 40.5, 41.5, and 43.7. In SEM views, the mouth evidenced a pair of lateral lips of equal size in a half-moon shape. Each lip featured a couple of labial papillae and a small amphid located between the 2 papillae. The hooklets on the head bulb had single-pointed, posteriorly-curved tips. The cuticular spines were larger and more densely distributed on the anterior part of the body, and decreased gradually in size and number toward the posterior body. On the basis of these morphological characteristics, the larvae were identified as the third stage larvae of Gnathostoma hispidum.

Gnatostomiasis tras un viaje a China para realizar una adopción internacional / Gnathostomiasis after a trip to China for international adoption

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Gnathostomiasis: a rare nematode infection.

Gnathostoma, primarily an animal nematode, can infect human by the third stage larva by consumption of undercooked or raw fish, poultry, or pork. In Bangladesh gnathostomiasis is a very rare condition. The first case, an ocular infection by gnathostoma was reported in 2001 from Rangpur, a northern district. This is the second case report of gnathostomiasis which also is an ocular infection, occurred in an area of greater district of Rangpur. A female patient of 32 year of age of the northern district, Nilphamari has got infected with a species of Gnathostoma, manifested by the appearance of a live larva near the right lateral margin of anterior surface of iris of her right eye. The larva was removed surgically from her eye and the patient was cured from symptoms.

Gnatostomiasis: una enfermedad creciente en viajeros / Gnathostomiasis: an increasing disease among travellers

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[Gnathostomiasis: an emerging parasitic disease?]. / La gnathostomose, une parasitose émergente?

INTRODUCTION: Human gnathostomiasis is a parasitic disease caused by the ingestion of foods contaminated with the larvae of various species of Gnathostoma. This zoonosis is currently endemic in Asia and Central America. CASE REPORT: A 46-year-old French woman resident in Vietnam presented with intermittent pruritic swelling of the hand, present for one year, coupled with eosinophilia. The patient's history and serological testing confirmed the suspected diagnosis of gnathostomiasis. A favorable outcome was attained on treatment with albendazole. DISCUSSION: This case, together with several others recently reported in France and Europe, underlines the need to inform travelers and migrants to endemic regions of the risks associated with eating raw or marinated fish.

Gnathostomiasis: clinicopathologic study.

Gnathostomiasis is a systemic parasitic disease that is caused by the ingestion of contaminated raw fish, the intermediate host. Involvement of the skin is a common event, and when it does happen, it can produce a superficial or creeping eruption, pseudofurunculosis, and nodular migratory panniculitis. We carried out a retrospective study of 946 cases of gnathostomiasis; 66 of them had skin biopsies. The diagnosis was made based on clinical and epidemio-logic findings as well as the therapeutic response. The most common skin finding was nodular migratory panniculitis affecting the trunk. Most of the patients were males between 20 and 40 years of age. Histopathologically, we were able to see the larva and make a definitive diagnosis in 15 cases, and in 12 cases, the worm was retrieved during the surgical procedure. In remaining cases, despite of our inability to identify the larva, the histopathologic changes were quite characteristic and included: dermal and hypodermal edema with dense mixed infiltrates composed of eosinophils admixed with lymphocytes and neutrophils, eosinophilic vasculitis, flame figures, areas of necrosis, and hemorrhage. Thus, the presence of these histopathologic features in the context of a clinical picture suggestive of gnathostomiasis allows the pathologist to make the correct diagnosis.

A note on the correlation between rainfall and the prevalence of Gnathostoma spp. infective stage larvae in swamp eels in Thailand.

Gnathostoma spinigerum is the major causative agent of human gnathostomiasis, a parasitic zoonosis with a great variety of clinical manifestations. Generally, humans are infected by consumption of third-stage larvae (L3) of G. spinigerum in infected hosts in the form of partially cooked or uncooked food. Surveys of the contamination of Gnathostoma spp. L3 in swamp eels are useful for prevention and control of diseases and have been continuously performed in Thailand. The author performed a retrospective study on 33 previous cross-sectional surveys with geographical data and the prevalence of Gnathostoma spp. L3 that covered 12 provinces in Thailand. The relation between rainfall (derived from the geographical data) and the prevalence of Gnathostomo spp. L3 in swamp eels (derived from the overall infection rate of Gnathostoma spp. L3) was investigated. The least-square equation plot rainfall (y) versus prevalence (x) is y= 9.68x + 1,035.12 (r = 0.83; p < 0.01). A significant correlation was discerned between rainfall and the prevalence of eel infection but not for the season of the survey. Similar to the previous study, the prevalence of eel infection may depend on rainfall rather than season. However, this study focused on only 33 cross-sectional surveys in Thailand; further similar study in other countries to assess the correlation between rainfall and the prevalence of infection is required to substantiate this conclusion.

Spontaneous larval Gnathostoma nipponicum infection in frogs.

From June 1993 to September 1997, a survey was carried out for the prevalence of larval Gnathostoma nipponicum infection in several kinds of frogs, toads, and their tadpoles collected from an endemic area of this nematode in Aomori Prefecture. Two frog species, one of 436 (0.2%) Rana nigromaculata and 51 of 147 (34.7%) R. catesbeiana were infected, and a total of 446 advanced third-stage larvae (AdL3) of G. nipponicum were recovered. These results confirmed that two frog species which can serve as the second intermediate and/or paratenic hosts in the life cycle of G. nipponicum exist in nature. This report is the first record of spontaneous infection of frogs with AdL3 of G. nipponicum.

Susceptibility of some vertebrate hosts to infection with early third-stage larvae of Gnathostoma hispidum.

Susceptibility of some vertebrates was examined to the early third-stage larvae (EL3) of Gnathostoma hispidum. The larvae collected from the Chinese loaches were infected to 4 silk carps, 3 snake heads, 3 bullfrogs, 5 mice and 9 albino rats. No worms were detected in fish, silk carps and snake heads. In 3 bullfrogs fed 30 larvae, a total of 9 EL3 was recovered in the gastrointestinal tract (8 larvae) and liver (one). In 5 mice infected with 50 larvae, a total of 37 (74.0%) advanced third-stage larvae (AdL3) was recovered from the muscle (31 larvae), liver (5 larvae) and kidney at 4 weeks after infection. In 9 albino rats infected with 115 larvae, a total of 40 (34.8%) AdL3 was found in the muscle. The mammalian hosts were found susceptible to the EL3 of G. hispidum from Chinese loaches.

Survey for Gnathostoma nipponicum larvae in gobiid freshwater fish and infectivity of the larvae to a gobiid fish (Chaenogobius urotaenia).

From June 1993 to November 1996, a total of 977 gobiid fish consisting of three species (Tridentiger brevispinis, Chaenogobius urotaenia, and Rhinogobiu brunneus) collected from eastern Aomori Prefecture, were examined for Gnathostoma nipponicum larvae infection. Only one species, C. urotaenia was infected with advanced third-stage larvae (AdL3), and a total of 22 larvae were recovered from 17 (3.4%) of 500 fish. The infected fish were larger than 12 cm in body length and collected in the May-June and September-November seasons. Experimental studies confirmed that C. urotaenia was susceptible to both the early third-stage larvae (EaL3) obtained from Eucyclops serrulatus and AdL3 from Misgurnus anguillicaudatus. Eight of 10 C. urotaenia inoculated orally with 10 EaL3 were positive, and 36 AdL3 were recovered from them (recovery rate: 36.0%) at 30 days postinoculation (PI). All 10 C. urotaenia inoculated with 10 AdL3 were also positive, and a total of 63 AdL3 were recovered (recovery rate: 63.0%) at 10 days PI. The main location of the larvae was the body muscles of the fish. No morphological alterations or death of the larvae were observed in this study. From these results, it seems that the C. urotaenia has characteristics suitable to be the host to the larvae and they may serve as the second intermediate and paratenic host in the natural life cycle of this nematode.

Comunicación de un caso de gnathostomiasis humana / Human gnathostomiasis one case confirmed

La gnathostomiasis humana es una enfermedad endémica con mayor prevalencia en países de Asia, particularmente Tailandia y Japón. La causa más frecuente de esta parasitosis es la ingestión del nemátodo Gnathostoma spinigerum. La gnathostomiasis en el hombre se presenta con manifestaciones cutáneas o viscerales de gravedad variable. En la mayoría de los casos los síntomas no son graves; sin embargo, si el número de larvas o el sitio de ubicación es en los órganos vitales, pueden sobrevenir síntomas agudos con secuelas serias e incluso la muerte del individuo. El diagnóstico definitivo se basa en la identificación de la larva obtenida por una biopsia de piel. El único tratamiento eficaz es la remoción de la larva, pero esto debe hacerse en condiciones óptimas. Se recomienda el tratamiento con albendazol, 500 mg al día durante 21 días, para reducir la morbilidad larvaria y facilitar su extirpación. Se comunica la experiencia con un caso

Gnatostomiasis intraocular: caso anatomoclínico

La gnatostomiasis humana es una enfermedad rara, cuya frecuencia aumentó en los últimos años; es ocasionada por la infestación de un nematodo, Gnathostoma, el cual se adquiere por ingestión de pescado crudo. El presente trabajo describe el caso de una paciente de 27 años de edad, residente de Uxpanapa, Ver., a quien se le encontró una larva de 3er. estadio alojada en la cámara anterior del globo ocular derecho, que se extrajo quirúrgicamente con éxito; se identificó como Ghathostoma probablemente spinigerum.