Cases reported "Spirurida Infections"

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1/8. gnathostomiasis possibly caused by gnathostoma malaysiae.

    gnathostomiasis is rarely reported in travelers, although the disease remains a major public health problem in Southeast asia. A creeping eruption and Quincke's edema (slowly migrating erythema with pruritus) appeared in two Japanese men who had eaten raw freshwater shrimp in myanmar. A gnathostoma larva was found in subcutaneous tissue from one of the men. Four species causing human gnathostomiasis, G. hispidum, G. doloresi, G. nipponicum and G. spinigerum, can be distinguished based on the number of nuclei in intestinal epithelial cells of infected larvae, in cross-section. In G. hispidum, only a single large nucleus is found. Morphologically, our larva was initially identified as G. hispidum. However, since the number of epithelial cells was greater and the body width was larger than those of a "large-type" 3rd-stage larva of G. hispidum, the larva was then identified as a 3rd-stage larva of G. malaysiae, Miyazaki and Dun, 1965, as reported by Setasuban et al, (1991). Since no human cases caused by this species of gnathostoma have previously been encountered, this appears to be the first report of gnathostomiasis due to G. malaysiae.
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2/8. Creeping eruption caused by a larva of the suborder spirurina type X.

    We report a case of creeping eruption caused by a larva of the suborder spirurina type X, which developed in a 46-year-old Japanese male. The patient ate small raw squids (Watasenia scintillans) 5 days before the onset of symptoms. On examination, an approximately 25-cm-long serpiginous red track with vesicles was observed from the right to the upper left side of the abdomen of the patient. Histological examination revealed the transverse section of a larval worm in the upper to middle dermis.The patient serum was positive only for the antibody against larvae of the suborder spirurina type X in ELISA, and negative for all other anti-parasite antibodies. Because a considerable number of people are fond of eating raw or nearly-raw fish and shellfish in japan, opportunities for developing creeping eruption cause by parasites present in raw fish and shellfish are relatively high.
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3/8. A human case of gnathostomiasis nipponica confirmed indirectly by finding infective larvae in leftover largemouth bass meat.

    A human case of creeping eruption due to gnathostoma nipponicum was confirmed indirectly by finding infective advanced third-stage larvae in leftover largemouth bass meat. This is the first report indicating that the largemouth bass (Micropterus salmoides) serves as a source of G. nipponicum infection in humans.
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4/8. A case report of colonic ileus due to eosinophilic nodular lesions caused by gnathostoma doloresi infection.

    gnathostomiasis is primarily a disease of the skin characterized as creeping eruption or mobile erythema. However, larval gnathostoma sometimes migrate into an unexpected site to elicit serious illness. Here we describe a case of colonic ileus caused by gnathostoma doloresi. The patient was a 57-year-old man living in Miyazaki Prefecture, japan, which is known as an area endemic for this parasite. One week after having eaten a few slices of the flesh of a snake (agkistrodon halys), he developed severe abdominal pain. An abdominal radiograph revealed multiple gas-fluid levels with a distended bowel of an inverted U shape. A barium enema revealed a tumor in the ascending colon near the hepatic flexure that was surgically removed by simple colonic resection. An oblique section of a parasite surrounded by massive infiltration of eosinophils was found by postoperative histopathologic examination. The entire body of the advanced third-stage larva of G. doloresi was dissected from a specimen-embedded paraffin block.
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5/8. Linear lichen planus mimicking creeping eruption.

    A 42-year-old woman was referred to our hospital with a linear eruption on her right flank of two months duration. Because she had eaten loach-fish a month before she noticed the eruption, a creeping eruption due to gnathostoma spp. was initially suspected, but the histological findings of the biopsy specimens showed typical features of lichen planus. Linear lichen planus is discussed based on the cases accumulated in the literature regarding the distribution of Blaschko lines.
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6/8. Current status of gnathostomiasis dorolesi in Miyazaki Prefecture, japan.

    gnathostomiasis is an important food-borne parasitic zoonosis caused mainly by ingesting uncooked or undercooked flesh of freshwater fishes. Although four distinct species of the genus gnathostoma were identified as the causative agents for human gnathostomiasis, human infections with G. doloresi have been found only in japan, concentrated in Miyazaki Prefecture. So far we have found 25 cases in Miyazaki Prefecture. Although most of these patients were of cutaneous gnathostomiasis, two patients presented to the hospital with unusual clinical manifestations; one case was a pulmonary gnathostomiasis diagnosed by immunoserological methods, and the other was an ileus caused by migration of the late 3rd stage larva in the colonic tissue, which was found by post-operative histopathological examination. Although cutaneous lesions such as creeping eruption or mobile erythema are the common clinical features of gnathostomiasis, caution should be paid to the presence of such unusual cases.
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7/8. Creeping eruption caused by a larva of the suborder spirurina type X.

    We report a 40-year-old Japanese man with a creeping eruption caused by a larva of the nematode suborder spirurina type X. He had eaten raw small squid (hotaruika) 4 weeks before the serpiginous erythematous eruption appeared on his abdomen. Routine laboratory tests revealed only slight eosinophilia in his peripheral blood. Although we could not find the larva in an excised skin specimen, an indirect immunofluorescence test confirmed the presence of antibodies against larvae of the suborder spirurina type X. We review 28 reported cases in japan which showed that creeping eruption caused by larvae of the suborder spirurina type X has the following clinical characteristics: an incubation time of 1-4 weeks; a migratory, well-defined, narrow, serpiginous erythematous eruption; and only slight peripheral blood eosinophilia. Excision of the advancing end of the track was curative in our patient.
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8/8. Human gnathostomiasis caused by gnathostoma doloresi, with particular reference to the parasitological investigation of the causative agent.

    gnathostomiasis caused by gnathostoma doloresi Tubangui was observed in a 46-year-old Japanese man, a clerk, who resided in the Fukuoka prefecture of Kyushu district, in southern japan. The first symptom noted by the patient was epigastric pain, which occurred 3 days after he had consumed the raw flesh of a brook trout, oncorhynchus masou masou (Brevoort), from a trout farm in neighbouring Kumamoto prefecture. Three days later, he developed creeping eruptions on his trunk. The eruptions spread and the patient was admitted to hospital 18 days after eating the trout. No nematode larvae were found in any of four skin biopsies collected on admission. However, vesicles appeared on the lower abdomen of the patient 20 days after he had eaten the trout, and a small nematode was removed from one of them. One day after the nematode had been excised, a cutaneous swelling suddenly occurred on the patient's lower left jowl and this persisted for a week. All the skin abnormalities gradually decreased from day 25 post-ingestion and had disappeared by day 30. The isolated nematode was identified as an advanced third-stage larva of G. doloresi, based on its morphology and the number of hooklets on its head-bulb.
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