Gnathostomiasis : Two cases admitted to Nong Khai Hospital, Thailand

Abstract

Human gnathostomiasis is a well-known parasitic infection widely-distributed in Thailand, Japan, and Latin America. Since 1985, there have been 65 cases of gnathostomiasis in Nong Khai Hospital. There were two types of clinical manifestations, of which intermittent migratory cutaneous swelling was more common than visceral larval migrans. This is a report of two cases of visceral organ manifestation of human gnathostomasis admitted to Nong Khai Hospital. The first case presented with hematemesis, endoscopy was done, and fortunately a gnathostome was found. The symptoms disappeared after removal of the parasite. The worm was identified as male Gnathostoma spinigerum. The second case presented symptoms of radicular pain on the abdomen and chest, which developed into paraplegia. The parasite was not found in this case but the diagnosis was made by magnatic resonance imaging and immunoblot, which showed a specific band for gnathostomiasis spinigerum. Radicular pain was decreased at the time paraplegia developed and the patient had not recovered, even after a full course of albendazole treatment (800 mg × 21 days).