Proteins from crude extracts of advanced third-stage larvae and adult Gnathostoma binucleatum nematode worms showed protein profiles in SDS-PAGE analysis similar to Echinococcus granulosus, Trichinella spiralis, Dipylidium caninum, Ancylostoma caninum, Ascaris lumbricoides and Toxocara canis. The immunoblot analysis of the human serum infected or suspected to be infected with G. binucleatum using the total larvae extract recognized the 40, 60, 80 and 115 kDa proteins and using the total adult worm extract recognized only the 80 and 115 kDa proteins. However, the 115 kDa protein showed cross-reactions with A. caninum, A. lumbricoides, T. canis and D. caninum with human serum positive to gnathostomosis, while the 40 kDa protein was only recognized with the G. binucleatum total larvae extract. The results obtained suggest that the use of antigens from the advanced third-stage larvae of the parasite were best recognized for immunodiagnosis of gnathostomosis.
Morphological abnormalities were observed on the cephalic bulb hooklets of advanced third-stage larvae (AdvL(3)) of genus Gnathostoma. The larvae were obtained from the fish "Mexican rivulus" Millerichthys robustus collected from a seasonal pond near Tlacotalpan, Veracruz, Mexico. The abnormalities involved (1) extra rudimentary hooklets, located between the four rows and after the fourth row, (2) branched or lobulated hooklets, and (3) fragmented hooklets not uniformly disposed in rows. The alterations observed on the cephalic bulb hooklets do not represent intraspecific variations, and they may be considered as a potential tool for assessing the presence of pollutants or stressors located within the ecosystem.
A 42‐year‐old woman was first seen in January 1996 with a 7‐cm diameter erythematous–edematous, pruritic plaque on her right shoulder. The lesion had first appeared 3 weeks previously on the right side of the thorax and migrated to the shoulder. The patient had eaten raw fish (sashimi) in Japanese restaurants two or three times a year during the past few years.
The presence of a migrating, pruritic, erythematous, and edematous plaque was clinically suggestive of nodular migratory eosinophilic panniculitis, also known as deep larva migrans or gnathostomiasis. The suspicion was further strengthened by the presence of 12% eosonophilia in the blood cell count.
The patient was given albendazole, 400 mg/day for 7 days. Seven days after treatment, the lesion disappeared. Three months later the patient returned with a new lesion that had evolved over 1 month, similar to the previous one, but on the left side of the thorax. This time there was no history of the ingestion of raw fish, and therefore a relapse of gnathostomiasis was suspected. The patient was given 200 μg of ivermectin orally for two consecutive days. Again, 1 week after treatment the lesion disappeared, only to relapse 2 months later. This time the lesion evolved over 12 h. When the patient was seen, a 2‐cm diameter excoriated, urticaria‐like, pruritic nodule was present in the left scapular area (Fig. 1A). In an attempt to remove the parasite, a deep, 8‐mm punch biopsy was performed in the center of the lesion. A sagittal cut of the complete parasite was present in one of the histopathologic slides (Fig. 1B). Based on the epidemiologic and morphologic characteristics, the parasite was classified as Gnathostoma spingerum. After removal of the parasite, the patient has remained free of symptoms for over 2 years.
1
(A) Excoriated, pruritic, urticaria‐like nodule in the scapular area. (B) Sagittal cut of Gnathostoma spingerum in a skin biopsy surrounded by a heavy inflammatory cell infiltrate: (a) head bulb; (b) intestine (hematoxylin and eosin, 10×)
Helmintos del pez anual Millerichthys robustus (Teleostei: Rivulidae), una especie endémica de México
Helminth of the annual fish Millerichthys robustus (Teleostei: Rivulidae), an endemic species to Mexico
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