Survival of immature pre-adult Gnathostoma spinigerum in humans after treatment with albendazole

Abstract

Human gnathostomiasis is a food-borne zoonotic helminthic infection widely reported in Latin America, Asia and Southeast Asia, particularly in Thailand. There are increasing reports of the parasite in countries where it is not endemic. A study of the survival drug-treated immature stage (STIM) of Gnathostoma spinigerum recovered from infected patients focused on their integument surface using scanning electron microscopy (SEM). STIM displayed a specific, characteristic head bulb, with a pair of large thick equal-sized trilobulated lips in the centre. Cephalic spines had eight transverse rows on the head bulb with single-ended tips curved posteriorly. Body cuticular spines on the anterior half of the STIM were not sharp-pointed but distributed more densely, with multi-dentated-cuticular spines, irregularly arranged in a lining pattern of velvety cuticular folds. The length of cuticular spines increased caudally. The size of spines became gradually smaller, and numbers decreased towards the posterior end. Spines were still widely dispersed posteriorly as their density dropped. The morphology of STIM of G. spinigerum are described in detail for the first time. These specimens showed structural adaptation based on changes on integument surfaces, probably to protect against damage induced by the toxic effects of albendazole.

Efficacy of triple dose albendazole treatment for soil-transmitted helminth infections

“…Besides, a recent study on Gnathostoma spinigerum reported the survival of immature preadult worm in human following albendazole treatment [64]. In that study, alteration on integument surfaces was noticed from surviving albendazole-treated larvae, postulated structural adaptation induced by the worm to protect against effect of albendazole.…”

Detection of Gnathostoma spinigerum larva in the brain with complete follow-up after surgical treatment of human neurognathostomiasis

“…Some cases may respond well to corticosteroids alone, without anthelminthic treatment ( Smith et al, 2021 ). For our patient, ivermectin (0.2 μg/kg) was administered as an alternative medication instead of albendazole for two consecutive days, following recommendations for treating gnathostomiasis ( Nontasut et al, 2005 ; Kanjanapruthipong et al, 2022 ). Albendazole and ivermectin monotherapy or in combination have been effective with initial experienced treatment failure ( Chappuis et al, 2001 ; Parola et al, 2004 ).…”

Zoonotic parasites with significant importance for tropical dermatology

“…New migratory lesions refer to the persistence of living parasites which would require the initiation of a new course of treatment. Challenges also involve cerebral edema; hence oral steroids are advisable [172] .…”