1
|
Park DS, Cho EH, Park KH, Jo SM, Park B, Huh S. A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea. PARASITES, HOSTS AND DISEASES 2023; 61:298-303. [PMID: 37648235 PMCID: PMC10471466 DOI: 10.3347/phd.23065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/23/2023] [Indexed: 09/01/2023]
Abstract
This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-year-old Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 μm to 235 μm. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the third-stage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.
Collapse
Affiliation(s)
- Doo Sik Park
- Department of Otorhinolaryngology, Hallym University Sacred Heart Hospital, Anyang 14068,
Korea
| | - Eun Hyun Cho
- Department of Otorhinolaryngology, Hallym University Sacred Heart Hospital, Anyang 14068,
Korea
| | - Kyung Hoon Park
- Department of Otorhinolaryngology, Hallym University Sacred Heart Hospital, Anyang 14068,
Korea
| | - Soo Min Jo
- Department of Otorhinolaryngology, Hallym University Sacred Heart Hospital, Anyang 14068,
Korea
| | - Bumjung Park
- Department of Otorhinolaryngology, Hallym University Sacred Heart Hospital, Anyang 14068,
Korea
| | - Sun Huh
- Department of Parasitology and Institute of Medical Education, College of Medicine, Hallym University, Chuncheon 24252,
Korea
| |
Collapse
|
2
|
Prakhunhungsit S, Thoongsuwan S, Boonsopon S, Panawattanawong T, Amornvararak P, Rodanant N, Phasukkijwatana N. Subretinal gnathostomiasis: A successful focal laser photocoagulation for a living parasite. Am J Ophthalmol Case Rep 2022; 26:101413. [PMID: 35243155 PMCID: PMC8861398 DOI: 10.1016/j.ajoc.2022.101413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose To report a case of subretinal gnathostomiasis presenting with progressive subretinal tracts of a living parasite and successfully treated with focal laser photocoagulation. Method Observational case report. Patient A 29-year-old Thai male complained of blurred vision and floaters in his left eye for two weeks. An ocular examination showed multiple, whitish, subretinal tracks at the superotemporal retina. After 5 days of oral albendazole, a moving parasite was confirmed by multimodal retinal imaging. An immunoblotting analysis was positive for Gnathostoma species. Result The patient was treated by laser photocoagulation with frequency-doubled Nd:YAG laser around and over the parasite. Oral albendozole was continued and naproxen was prescribed for four weeks. His vision improved to 20/20 and the inflammation subsided completely within three months. The patient has been followed for five years without local and systemic complications. Conclusions Focal laser photocoagulation without systemic steroids could be a successful treatment for active subretinal gnathostomiasis with a satisfactory safety profile in a long-term follow-up.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Nopasak Phasukkijwatana
- Corresponding author. Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, 10700, Thailand. Fax: +66 (0) 2411 1906. Tel: +66 (0) 2419 8033.
| |
Collapse
|
3
|
Kongwattananon W, Wiriyabanditkul T, Supwatjariyakul W, Somkijrungroj T. Intracameral Gnathostomiasis: A Case Report and Literature Review. Ocul Immunol Inflamm 2022:1-5. [PMID: 35588303 DOI: 10.1080/09273948.2022.2073239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this article is to report a case of ocular gnathostomiasis presenting with acute anterior uveitis and uveitis glaucoma. METHODS observational case report and literature review. RESULTS A 56-year-old Thai male was referred to a tertiary eye center with acute anterior uveitis and uveitis glaucoma in the right eye. A nematode was found in the right anterior chamber. Surgical removal of the nematode was successfully performed. Gnathostoma spinigerum was the nematode identified on pathological examination. CONCLUSIONS Early detection of the parasite and timely surgical removal is the key to the management of ocular gnathostomiasis.
Collapse
Affiliation(s)
- Wijak Kongwattananon
- Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Thanaporn Wiriyabanditkul
- Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Waraluck Supwatjariyakul
- Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Thanapong Somkijrungroj
- Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| |
Collapse
|
4
|
Eiras JC, Pavanelli GC, Takemoto RM, Nawa Y. An Overview of Fish-borne Nematodiases among Returned Travelers for Recent 25 Years- Unexpected Diseases Sometimes Far Away from the Origin. THE KOREAN JOURNAL OF PARASITOLOGY 2018; 56:215-227. [PMID: 29996625 PMCID: PMC6046559 DOI: 10.3347/kjp.2018.56.3.215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/06/2018] [Accepted: 05/14/2018] [Indexed: 12/12/2022]
Abstract
Along with globalization of traveling and trading, fish-borne nematodiases seems to be increasing in number. However, apart from occasional and sporadic case reports or mini-reviews of particular diseases in particular countries, an overview of fish-borne nematodiasis among travelers have never been performed. In this review, we gathered fishborne nematodiasis among travelers for recent 25 years by an extensive global literature survey using appropriate keywords, e.g. travelers diseases, human infection, anisakiasis, gnathostomiasis, capillariasis, sushi, sashimi, ceviche, Gnathostoma, Pseudoterranova, Anisakis, Capillaria, etc., as well as various combinations of these key words. The Internet search engines PubMed, Medline, Google and Googler Scholar were used as much as possible, and the references of every paper were checked in order to identify useful and reliable publications. The results showed unexpectedly high incidence of gnathostomiasis and low incidence of anisakidosis. The different incidence values of the infection with several fish-borne zoonotic nematode species are discussed, as well as some epidemiological aspects of the infections. The difficulties of differential diagnosis in non-endemic countries are emphasized. It is concluded that travelers must avoid risky behaviors which can lead to infection and that physicians and health authorities must advice travelers on the risks of eating behaviors during travel.
Collapse
Affiliation(s)
- Jorge Costa Eiras
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007 Porto, Portugal
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos, 4450-308 Matosinhos, Portugal
| | - Gilberto Cezar Pavanelli
- Unicesumar, Programa de pós-graduação em Promoção da Saúde, Bloco 7, Avenida Guerner Dias, 1610-Jardim Aclimação, Maringá-PR, 87050-900, Brasil
- Pesquisador do Instituto Cesumar de Ciência, Tecnologia e Inovação, Bloco 11-50 andar (44) 3027-6360 Ramal 1346, Brasil
| | | | - Yukifumi Nawa
- Tropical Diseases Research Center, Faculty of Medicine, Khon Kaen University, 123 Mitrapap Highway, Khon Kaen 40002, Thailand
| |
Collapse
|
5
|
Hamilton WL, Agranoff D. Imported gnathostomiasis manifesting as cutaneous larva migrans and Löffler's syndrome. BMJ Case Rep 2018; 2018:bcr-2017-223132. [PMID: 29420245 PMCID: PMC5812380 DOI: 10.1136/bcr-2017-223132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 11/03/2022] Open
Abstract
Here, we report an unusual case of invasive gnathostomiasis in a returning traveller, with a shifting pattern of relapsing cutaneous disease. The previously fit and well 32-year-old man first presented with serpiginous, pruriginous erythematous tracks characteristic of cutaneous larva migrans shortly after returning from South-East Asia. He was systemically well with no other symptoms. After ivermectin therapy, he re-presented with respiratory symptoms, peripheral eosinophilia and transient pulmonary infiltrates; the classic triad of Löffler's syndrome associated with invasive helminth infection. Gnathostoma spinigerum immunoblot was positive. After a second round of ivermectin therapy his respiratory symptoms resolved, but the patient's cutaneous disease relapsed repeatedly over months, with migratory erythematous swellings appearing and settling after a few days. He was treated with a 21-day course of albendazole and is lesion free at 40 weeks post initial presentation.
Collapse
Affiliation(s)
- William L. Hamilton
- Acute Medical Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Daniel Agranoff
- Department of Infectious Diseases, Brighton and Sussex University Hospitals, Brighton, UK
| |
Collapse
|
6
|
Nawa Y, Yoshikawa M, Sawanyawisuth K, Chotmongkol V, Figueiras SF, Benavides M, Diaz Camacho SP. Ocular Gnathostomiasis-Update of Earlier Survey. Am J Trop Med Hyg 2017; 97:1232-1234. [PMID: 28722600 DOI: 10.4269/ajtmh.17-0133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Ocular gnathostomiasis is rather a rare food-borne zoonosis caused by infection with the larvae of several species of genus Gnathostoma and is a representative ocular larva migrans syndrome. In our previous literature survey, we found 73 cases of ocular gnathostomiasis reported up to and including 2009, though additional sporadic cases have been reported in Asia and the Americas since that report. Here, we review 10 additional cases reported since 2010, and also update current findings regarding epidemiological and clinical features in affected patients.
Collapse
Affiliation(s)
- Yukifumi Nawa
- Faculty of Medicine, Tropical Diseases Research Centre, Khon Kaen University, Khon Kaen, Thailand
| | - Masahide Yoshikawa
- Department of Parasitology, Nara Medical University, Kashihara, Nara, Japan
| | - Kittisak Sawanyawisuth
- Faculty of Medicine, Department of Medicine and Ambulatory Medicine Research Group, Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), and Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Faculty of Medicine, Department of Internal Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sandra Fernández Figueiras
- Sección de Microbiologia, Laboratorio de Microbiología y Biología Molecular, Centro Medico Docente la Trinidad, Caracas, Venezuela
| | - Maria Benavides
- Cornea Clinic, Ophthalmology Service, Centro Medico Docente la Trinidad, Caracas, Venezuela
| | | |
Collapse
|
7
|
Khanifar AA, Espiritu MJ, Myung JS, Aaker GD, Schuetz AN, D'Amico DJ, Chan RVP. Three-dimensional spectral domain optical coherence tomography and light microscopy of an intravitreal parasite. J Ophthalmic Inflamm Infect 2015; 5:33. [PMID: 26585462 PMCID: PMC4653122 DOI: 10.1186/s12348-015-0064-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/05/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Various imaging modalities play a role in diagnosing parasitic infections of the eye. We describe the spectral domain optical coherence tomography (SD-OCT) findings of an intravitreal parasite with subsequent evaluation by light microscopy. FINDINGS This is a case report of a 37-year-old Ecuadorian man who presented with uveitic glaucoma and a new floater in his left eye for 1 week's duration. Full ophthalmic examination revealed an intravitreal parasite. Color fundus photography, fluorescein angiography (FA), ocular ultrasonography (US), and SD-OCT were performed. The parasite was removed via 23-gauge pars plana vitrectomy and sent to pathology for evaluation. Color fundus photography and ocular ultrasonography demonstrated an elongated foreign body within the vitreous above the retina. FA demonstrated minimal vascular changes in the vicinity of the parasite. SD-OCT was utilized to visualize the parasite and to create a three-dimensional (3D) image. The parasite was determined to be most consistent with Gnathostoma spp. by morphologic analysis. CONCLUSIONS This is the first reported case of SD-OCT of an intravitreal parasite with corresponding evaluation by pathology. SD-OCT allows non-invasive, high-resolution visualization and 3D reconstruction of parasitic anatomy which may help establish tomographic criteria for species identification.
Collapse
Affiliation(s)
- Aziz A Khanifar
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
| | - Michael J Espiritu
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
| | - Jane S Myung
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
| | - Grant D Aaker
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
| | - Audrey N Schuetz
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Donald J D'Amico
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
| | - R V Paul Chan
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA.
| |
Collapse
|
8
|
Hem S, Tarantola A, Chheang R, Nop P, Kerléguer A. First reported case of intraocular Gnathostoma spinigerum in Cambodia. ACTA ACUST UNITED AC 2015; 108:312-5. [PMID: 26419485 DOI: 10.1007/s13149-015-0453-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
A live intraocular nematode was identified from a 37 year-old man presented with iritis, pain, redness, lacrimation, swelling, vision loss and intermittent blindness during many hours per day of the left eye. By using slit lamp examination, a worm was removed from iris in an ophthalmology outpatient department setting and sent to the Medical Microbiology Laboratory, Institut Pasteur du Cambodge. Gnathostoma spinigerum was identified, based on its typical morphology via microscopic examination. Based on our diagnosis, the patient was treated by oral albendazole and responded well to this therapy.
Collapse
Affiliation(s)
- S Hem
- Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodge
| | - A Tarantola
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodge
| | - R Chheang
- Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodge
| | - P Nop
- Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodge
| | - A Kerléguer
- Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodge.
| |
Collapse
|
9
|
|
10
|
Cui J, Wang Y, Wang ZQ. Cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia: a case report from China. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:467-70. [PMID: 24039291 PMCID: PMC3770879 DOI: 10.3347/kjp.2013.51.4.467] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 05/29/2013] [Accepted: 06/03/2013] [Indexed: 12/26/2022]
Abstract
The present study reports a human case of cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia in China. A 52-year-old woman from Henan Province, central China, presented with recurrent migratory reddish swelling and subcutaneous nodule in the left upper arm and on the back for 3 months. Blood examination showed eosinophila (21.2%), and anti-sparganum antibodies were positive. Skin biopsy of the lesion and histopathological examinations revealed dermal infiltrates of eosinophils but did not show any parasites. Thus, the patient was first diagnosed as sparganosis; however, new migratory swellings occurred after treatment with praziquantel for 3 days. On further inquiring, she recalled having eaten undercooked eels and specific antibodies to the larvae of Gnathostoma spinigerum were detected. The patient was definitely diagnosed as cutaneous gnathostomiasis caused by Gnathostoma sp. and treated with albendazole (1,000 mg/day) for 15 days, and the subsequent papule and blister developed after the treatment. After 1 month, laboratory findings indicated a reduced eosinophil count (3.3%). At her final follow-up 18 months later, the patient had no further symptoms and anti-Gnathostoma antibodies became negative. Conclusively, the present study is the first report on a human case of cutaneous gnathostomiasis in Henan Province, China, based on the past history (eating undercooked eels), clinical manifestations (migratory subcutaneous nodule and persistent eosinophilia), and a serological finding (positive for specific anti-Gnathostoma antibodies).
Collapse
Affiliation(s)
- Jing Cui
- Department of Parasitology, Medical College, Zhengzhou University, Zhengzhou 450052, Henan Province, P. R. China
| | | | | |
Collapse
|
11
|
Kim JH, Lim H, Hwang YS, Kim TY, Han EM, Shin EH, Chai JY. Gnathostoma spinigerum infection in the upper lip of a Korean woman: an autochthonous case in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:343-7. [PMID: 23864746 PMCID: PMC3712109 DOI: 10.3347/kjp.2013.51.3.343] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/29/2013] [Accepted: 05/29/2013] [Indexed: 11/23/2022]
Abstract
Autochthonous human gnathostomiasis had never been reported in the Republic of Korea. We report here a case of Gnathostoma spinigerum infection in a 32-year-old Korean woman, presumed to have been infected via an indigenous route. The patient had experienced a painful migratory swelling near the left nasolabial fold area of the face for a year, with movement of the swelling to the mucosal area of the upper lip 2 weeks before surgical removal of the lesion. Histopathological examinations of the extracted tissue revealed inflammation with heavy eosinophilic infiltrations and sections of a nematode suggestive of a Gnathostoma sp. larva. The larva characteristically revealed about 25 intestinal cells with multiple (3-6) nuclei in each intestinal cell consistent with the 3rd-stage larva of G. spinigerum. The patient did not have any special history of travel abroad except a recent trip, 4 months before surgery, to China where she ate only cooked food. The patient is the first recorded autochthonous case of G. spinigerum infection in Korea.
Collapse
Affiliation(s)
- Jae Hee Kim
- Department of Plastic and Reconstructive Surgery, Bundang Jesaeng General Hospital, Seongnam 463-774, Korea
| | | | | | | | | | | | | |
Collapse
|