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Albendazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Man is an end-stage host for this zoonotic infection. Although originally considered to be confined to Southeast Asia and to a small focus in Latin America, sporadic reports of Gnathostoma spinigerum infection indicate that it is far more widespread and can occur anywhere if raw or partially cooked freshwater fish is consumed. The migrating larvae can cause severe, sometimes lethal, damage to organs. Albendazole was the first drug demonstrated to be effective in clinical disease (Kraivichian et al., 1992; Suntharasamai et al., 1992; Houston, 1994; Jelinek et al., 1994; Vargas et al., 1998). The dose used ranges from 400 mg daily for 10 days to 800 mg for 21 days. More recently, studies of the comparative efficacy of albendazole and ivermectin have been reported (Kraivichian et al., 2004; Nontasut et al., 2005). Doses of albendazole 400 mg twice daily for 21 days and ivermectin 0.2 mg/kg for 2 days led to different results in these two studies, although both drugs were effective. Given the simpler dosage regimen, ivermectin is probably to be preferred if it is available.
Gnathostoma
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
O. Sanpool, P.M. Intapan, David Blair, Yukifumi Nawa, W. Maleewong
Gnathostomiasis is a harmful foodborne helminthic zoonosis caused by the migration of the Gnathostoma worm. In this chapter, we reviewed the biology, epidemiology, clinical features, pathogenesis, diagnosis, treatment, and control of gnathostomiasis. Gnathostoma spinigerum, G. doloresi, G. hispidum, G. nipponicum, G. malaysiae, and G. binucleatum have all been reported as causing human disease. Gnathostoma spinigerum is common in Asia, while G. binucleatum is the main causative agent of gnathosomiasis in the Americas. Advanced L3 larvae are the infective stage for humans, ingested with raw or improperly cooked meat contaminated with them. More than 40 species of fish, reptiles, amphibians, birds, and small mammals act as intermediate and paratenic hosts. Human gnathostomiasis commonly presents with a migratory swelling syndrome: vital organs might be infected, resulting in death or serious symptoms. Infection by skin penetration of larvae while handling contaminated flesh, and transplacental transmission, are possible. Diagnosis is dependent on identification of Gnathostoma worms recovered from patients, clinical manifestations, and serological tests. Albendazole or ivermectin have been used for the treatment, but their efficacy remains uncertain. Proper cooking of food is the best means of prevention. Gnathostomiasis cases have been increasing among international travelers returning from endemic countries. Clinicians in nonendemic areas therefore need to be aware of the clinical features of gnathostomiasis for early diagnosis and treatment. There are clear needs for research on rapid diagnostic tests, effective therapy, and evaluation of drug efficacy. Proteomic studies will assist the search for candidate proteins for diagnosis and vaccine/drug design and may provide better understanding of the host-parasite relationship in human gnathostomiasis.175
Role of Ultra-Wide-Field Imaging in the Diagnosis of Intravitreal Gnathostomiasis: A Case Report
Published in Ocular Immunology and Inflammation, 2019
Parveen Sen, Parthopratim Dutta Majumder, Jyotirmay Biswas, Chetan Rao, Kalpita Das
She underwent three-port 25-gauge pars plana vitrectomy. The worm was found entangled in the vitreous fibers which were carefully cut with a microvit using very low suction (Figure 1d). The worm was then engaged into the port of the 25-gauge aspiration needle and guided out of the sclerotomy. By morphologic analysis under the microscope, the worm was identified as Gnathostoma spinigerum. Complete posterior vitreous detachment as well as removal of ERM was done. Microscopic examination of the parasite confirmed it to be Gnathostoma spinigerum (Figure1e). Following surgical procedure, she was seen after a month when her BCVA improved to 6/18 and she was symptomatically better.
Intracameral Gnathostomiasis: A Case Report and Literature Review
Published in Ocular Immunology and Inflammation, 2023
Wijak Kongwattananon, Thanaporn Wiriyabanditkul, Waraluck Supwatjariyakul, Thanapong Somkijrungroj
Among five species of Gnathostoma identified as pathogenic for human, Gnathostoma spinigerum (G. Spinigerum) is the most common species involving the human eye.3,5 Ocular gnathostomiasis can occur years after the initial infection.3 The migration of the third-stage larvae to ocular tissue as well as host immune response to the larvae toxin results in various ocular complications.6 Anterior uveitis is the most frequently reported ocular manifestation and is often complicated by secondary glaucoma.7,8 Previously published intraocular gnathostomiasis case reports are summarized in Table 1.