Should the host reaction to anisakiasis influence the treatment?: Different clinical presentations in two cases

Abstract

Gastrointestinal anisakiasis is a parasitic infection occurring in people that consume raw or inadequately cooked fish or squid. It is frequently characterized by severe epigastric pain, nausea and vomiting caused by the penetration of the larvae into the gastric wall. Acute gastric anisakiasis with severe chest discomfort is rarely reported in Italy. On the other hand, gastro-allergic anisakiasis with rash, urticaria and isolated angioedema or anaphylaxis is a clinical entity that has been described only recently. Also, if patients usually develop symptoms within 12 hours after raw seafood ingestion, not always endoscopic exploration can promptly identify the Anisakis larvae. Moreover, some authors consider the prevailing allergic reaction as a natural and effective defense against the parasitic attack. We report two cases of peculiar manifestations of anisakiasis in both acute and chronic forms (severe chest discomfort and anaphylactoid reaction).

Natural products: Perspectives in the pharmacological treatment of gastrointestinal anisakiasis

“…Japan figures at the top of the list for this parasitosis, followed by Spain, due to the high level of fish consumption by inhabitant per year and the wide variety of high-risk preparation methods, although nowadays cases are reported all over the world. Various treatments have been proposed for this illness in cases where symptoms do not require urgent intervention, but in the last two decades clinicians have mainly opted for anthelmintics such as mebendazole, thiabendazole and especially albendazole in an effort to avoid surgery [7][8][9][10][11]. In fact, albendazole is listed as a treatment for anisakiasis on the Centers for Disease Control and Prevention webpage -Anisakiasis (USA) [12], although it points out that it is not FDA approved to treat this illness, as there is no clear evidence of its effectiveness.…”

First Comparative Redescription of Six Types of Larval Stages of Hysterothylacium sp. (Nematoda: Raphidascarididae) From Red Sea Fishes at Hurghada, Egypt

“…The present data refers to the possibility of one of the present described 4th stage larvae may be the infective stage of this nematode parasite and its life cycle is a direct one by engulfing larvae-infected fish. Hysterothylacium was described as a zoonotic parasite (Chai et al, 2005, Lopata and Lehrer, 2009, Felizardo et al, 2009 and the first case report of human infection with H. aduncum was reported by Yagi et al, (1996) in a patient complaining of epigastralgia , vomiting, obstruction, diarrhea, ulceration, bleeding and hypersensitivity reactions in the form of urticaria, angioedema, and shock (Pontone et al, 2012) and definite diagnosis can be done only by direct parasite visualization Henriquez-Santana and Villafruela-Cives, 2009).…”

Peppermint (Mentha piperita) and albendazole against anisakiasis in an animal model

“…Various drugs have been used against anisakiasis with no clear results. Single albendazole doses are effective for the treatment of Ascaris lumbricoides, Enterobius vermicularis and Trichuris trichiura, explaining its frequent use to combat human anisakiasis (Moore et al 2002;Pacios et al 2005;Kim et al 2006;Filauro et al 2011;Pontone et al 2012).…”