1
|
Nogrado K, Adisakwattana P, Reamtong O. Human gnathostomiasis: A review on the biology of the parasite with special reference on the current therapeutic management. Food Waterborne Parasitol 2023; 33:e00207. [PMID: 37719690 PMCID: PMC10502356 DOI: 10.1016/j.fawpar.2023.e00207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023] Open
Abstract
Gnathostoma is a parasitic nematode that can infect a wide range of animal species, but human populations have become accidental hosts because of their habit of eating raw or undercooked meat from a wide variety of intermediate hosts. While gnathostomiasis is considered an endemic disease, cases of human gnathostomiasis have been increasing over time, most notably in nonendemic areas. There are several complexities to this parasitic disease, and this review provides an update on human gnathostomiasis, including the life cycle, diagnosis, treatment, and treatment strategies used to combat drug resistance. Even now, a definitive diagnosis of gnathostomiasis is still challenging because it is difficult to isolate larvae for parasitological confirmation. Another reason is the varying clinical symptoms recorded in reported cases. Clinical cases can be confirmed by immunodiagnosis. For Gnathosotoma spinigerum, the detection of IgG against a specific antigenic band with a molecular weight of 24 kDa from G. spinigerum advanced third-stage larvae (aL3), while for other species of Gnathostoma including G. binucleatum, the 33-kDa antigen protein is being used. This review also discusses cases of recurrence of gnathostomiasis and resistance mechanisms to two effective chemotherapeutics (albendazole and ivermectin) used against gnathostomiasis. This is significant, especially when planning strategies to combat anthelmintic resistance. Lastly, while no new chemotherapeutics against gnathostomiasis have been made available, we describe the management of recurrent gnathostomiasis using albendazole and ivermectin combinations or extensions of drug treatment plans.
Collapse
Affiliation(s)
- Kathyleen Nogrado
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
2
|
Wang Y, Ma A, Liu XL, Eamsobhana P, Gan XX. Evaluation of Rapid IgG4 Test for Diagnosis of Gnathostomiasis. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:257-263. [PMID: 34218597 PMCID: PMC8255487 DOI: 10.3347/kjp.2021.59.3.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/23/2021] [Indexed: 12/01/2022]
Abstract
Human gnathostomiasis is a parasitic disease caused by Gnathostoma nematode infection. A rapid, reliable, and practical immunoassay, named dot immuno-gold filtration assay (DIGFA), was developed to supporting clinical diagnosis of gnathostomiasis. The practical tool detected anti-Gnathostoma-specific IgG4 in human serum using crude extract of third-stage larvae as antigen. The result of the test was shown by anti-human IgG4 monoclonal antibody conjugated colloidal gold. The sensitivity and specificity of the test were both 100% for detection in human sera from patients with gnathostomiasis (13/13) and from healthy negative controls (50/50), respectively. Cross-reactivity with heterogonous serum samples from patients with other helminthiases ranged from 0 (trichinosis, paragonimiasis, clonorchiasis, schistosomiasis, and cysticercosis) to 25.0% (sparganosis), with an average of 6.3% (7/112). Moreover, specific IgG4 antibodies diminished at 6 months after treatment. This study showed that DIGFA for the detection of specific IgG4 in human sera could be a promising tool for the diagnosis of gnathostomiasis and useful for evaluating therapeutic effects.
Collapse
Affiliation(s)
- Yue Wang
- Institute of Parasitic Diseases, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, P. R. China.,National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, P. R. China
| | - An Ma
- Institute of Parasitic Diseases, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, P. R. China
| | - Xiao-Long Liu
- Institute of Parasitic Diseases, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, P. R. China
| | - Praphathip Eamsobhana
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Xiao-Xian Gan
- Institute of Parasitic Diseases, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, P. R. China
| |
Collapse
|
3
|
Bravo FG. Emerging infections: mimickers of common patterns seen in dermatopathology. Mod Pathol 2020; 33:118-127. [PMID: 31685961 DOI: 10.1038/s41379-019-0399-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 11/09/2022]
Abstract
The following discussion deals with three emerging infection diseases that any dermatopathologist working in the northern hemisphere can come across. The first subject to be dealt with is gnathostomiasis. This parasitic disease is produced by the third larvarial stage of the parasite that in most patients is associated with the ingestion of raw fish. Epidemiologically, it is most commonly seen in South East Asia, Japan, China, and the American continent, mainly in Mexico, Ecuador, and Peru. Nowadays, the disease is also seen in travelers living in the developed countries who recently came back from visiting endemic countries. The disease produces a pattern of migratory panniculitis or dermatitis with infiltration of eosinophils in tissue. The requirements for making the diagnosis are provided, including clinical forms, common histological findings on skin biopsy as well as the use of ancillary testing. Buruli ulcer, a prevalent mycobacterial infection in Africa, is described from the clinical and histopathological point of view. The disease has been described occasionally in Central and South America as well as in developed countries such as Australia and Japan; Buruli ulcer has also been described in travelers returning from endemic areas. Clinically, the disease is characterized by large, painless ulcerations with undermined borders. Systemic symptoms are usually absent. Classical histological findings include a particular type of fat necrosis and the presence of abundant acid fast bacilli in tissue. Such findings should raise the possibility of this disease, with the purpose of early therapeutically intervention. Lastly, the infection by free living ameba Balamuthia mandrillaris, an emerging condition seen in the US and Peru, is extensively discussed. Special attention is given to clinical and histological characteristics, as well as to the clues for early diagnosis and the tools available for confirmation.
Collapse
Affiliation(s)
- Francisco G Bravo
- Universidad Peruana Cayetano Heredia, Hospital Cayetano Heredia, Lima, Peru.
| |
Collapse
|
4
|
Benavides MA, Baldo MB, Tauber S, Figueiras SF, Incani RN, Nawa Y. Case Report: Ocular Gnathostomiasis in Venezuela Most Likely Acquired in Texas. Am J Trop Med Hyg 2019; 99:1028-1032. [PMID: 30141392 DOI: 10.4269/ajtmh.18-0492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
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.
Collapse
Affiliation(s)
| | - Maria Belisa Baldo
- Cornea Clinic, Ophthalmology Service, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | - Shachar Tauber
- Ophthalmic Research and Telemedicine Section, Ophthalmology and Optometry Mercy Clinic, Caracas, Venezuela
| | - Sandra Fernandez Figueiras
- Section of Microbiology and Molecular Biology, Clinical Laboratory, Centro Medico Docente La Trinidad Caracas, Venezuela
| | - Renzo Nino Incani
- Department of Parasitology, Faculty of Health Sciences, Universidad de Carabobo, Valencia, Venezuela
| | - Yukifumi Nawa
- Tropical Diseases Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
5
|
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
|
6
|
Bravo F, Gontijo B. Gnathostomiasis: an emerging infectious disease relevant to all dermatologists. An Bras Dermatol 2018; 93:172-180. [PMID: 29723377 PMCID: PMC5916386 DOI: 10.1590/abd1806-4841.20187498] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/27/2017] [Indexed: 11/22/2022] Open
Abstract
Gnathostomiasis is a parasitic infection caused by the third larval stage of nematodes of the genus Gnathostoma. The disease is endemic in some countries around the world. In the American continent, the majority of cases is concentrated in Mexico, Ecuador, and Peru. However, due to increasing traveling either at the intercontinental or intracontinental level, the disease is seen each time more frequently in tourists. Furthermore, countries, such as Brazil, that have never been considered endemic are reporting autochthonous cases. The disease usually presents as a deep-seated or slightly superficial migratory nodule in patients with history of eating raw fish, in the form of ceviche, sushi, or sashimi. Along with the clinical presentation, diagnostic criteria include either blood or tissue eosinophilia. In most instances, these criteria are enough for the attending physician to institute therapy. Chances of finding the parasite are low, unless the biopsy is taken from a very specific area that develops after antiparasitic treatment is started. The potential of other organ involvement with more serious consequences should always be kept in mind.
Collapse
Affiliation(s)
- Francisco Bravo
- Discipline of Dermatology and Pathology, Universidad Peruana
Cayetano Heredia – Lima, Peru
- Service of Pathology, Hospital Cayetano Heredia – Lima, Peru
| | - Bernardo Gontijo
- Discipline of Dermatology, Faculdade de Medicina da Universidade
Federal de Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil
- Dermatology Unit, Hospital das Clinicas da Universidade Federal de
Minas Gerais (UFMG) – Belo Horizonte (MG), Brazil
| |
Collapse
|
7
|
A filtration-based rapid test using a partially purified third-stage larval antigen to detect specific antibodies for the diagnosis of gnathostomiasis. J Helminthol 2017; 93:26-32. [PMID: 29144215 DOI: 10.1017/s0022149x17001080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Human gnathostomiasis is an emerging food-borne parasitic disease caused by nematodes of the genus Gnathostoma. Currently, serological tests are commonly applied to support clinical diagnosis. In the present study, a simple and rapid filtration-based test, dot immune-gold filtration assay (DIGFA) was developed using a partially purified antigen of Gnathostoma third-stage larvae (L3). A total of 180 serum samples were tested to evaluate the diagnostic potential of DIGFA for gnathostomiasis. The diagnostic sensitivity and specificity were 96.7% (29/30) and 100% (25/25), respectively. The cross-reactivity with sera from other helminthiasis patients ranged from 0 to 4%, with an average of 1.6% (2/125). DIGFA using a partially purified L3 antigen was not only simple and rapid, but also more accurate than standard assays for the diagnosis of human gnathostomiasis. DIGFA may represent a promising tool for application in laboratories or in the field, without requiring any instrumentation.
Collapse
|
8
|
Leroy J, Cornu M, Deleplancque AS, Loridant S, Dutoit E, Sendid B. Sushi, ceviche and gnathostomiasis - A case report and review of imported infections. Travel Med Infect Dis 2017; 20:26-30. [DOI: 10.1016/j.tmaid.2017.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/13/2017] [Accepted: 10/14/2017] [Indexed: 11/30/2022]
|
9
|
Cornaglia J, Jean M, Bertrand K, Aumaître H, Roy M, Nickel B. Gnathostomiasis in Brazil: an emerging disease with a challenging diagnosis. J Travel Med 2016; 24:taw074. [PMID: 27799501 DOI: 10.1093/jtm/taw074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/29/2016] [Indexed: 11/14/2022]
Abstract
This case report describes the second reported case of gnathostomiasis acquired in Brazil. The French traveller returned from a sport fishing trip from Tocantins where he was repeatedly consuming raw freshwater fish marinated with lemon juice. Gnathostoma infection was diagnosed based on clinical symptoms, dietary record and by detection of specific antibodies in the blood.
Collapse
Affiliation(s)
- Julian Cornaglia
- Infectious and Tropical Diseases Departement, Perpignan Hospital Center, Perpignan, France
| | - Maxime Jean
- Infectious and Tropical Diseases Departement, Perpignan Hospital Center, Perpignan, France
| | - Kevin Bertrand
- Infectious and Tropical Diseases Departement, Perpignan Hospital Center, Perpignan, France
| | - Hugues Aumaître
- Infectious and Tropical Diseases Departement, Perpignan Hospital Center, Perpignan, France
| | - Melisande Roy
- Infectious and Tropical Diseases Departement, Perpignan Hospital Center, Perpignan, France
| | - Beatrice Nickel
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| |
Collapse
|