Abstrait

Gnathostomiasis.

Shawn Kruger

Gnathostomiasis is a nematode illness caused by the worm Gnathostoma spinigerum that was once only found in Southeast Asia, notably Thailand and Japan, but has now spread to Central and South America and Mexico as a result of raw fish consumption in ceviche. Infection is obtained by consuming uncooked food contaminated with the larval third stage, which can be found in fish, shrimp, crab, crayfish, frog, or chicken. In endemic regions, cats and dogs serve as significant reservoirs. Because the larva cannot grow into the adult form in humans, it wanders through host tissues, generating an inflammatory response. Clinical symptoms include the skin and subcutaneous tissues, the eye, the viscera, and, in rare cases, the central nervous system. The most frequent skin symptoms are migratory subcutaneous swellings that last several days or, less commonly, cutaneous larva migrans. The latter is a pruritic, linear, serpiginous rash that develops inside the dermis and is less likely to be seen on the foot than dog or cat hookworm acquired via beach walking. Gnathostomiasis has a varied incubation time, although symptoms generally appear within a few months of consuming infected food. Depending on the geographic history, the primary differential diagnoses for gnathostomiasis include loiasis (Loa loa), fascioliasis, myiasis, and paragonimiasis, as well as strongyloidiasis and cutaneous larva migrans from dog or cat hookworms in the case of dermal involvement.