Should the host reaction to anisakiasis influence the treatment? Different clinical presentations in two cases.
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).
Department of Surgical Sciences, Sapienza University of Rome, Italy. stefano.pontone@uniroma1.it
Stefano
S
Pontone
Giovanni
G
Leonetti
Eleonora
E
Guaitoli
Renzo
R
Mocini
Simone
S
Manfredelli
Antonio
A
Catania
Paolo
P
Pontone
Salvatore
S
Sorrenti
D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D017129:Anisakiasis / Q000469:parasitology* / Q000473:pathology / Q000628:therapy*; D017163:Anisakis; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000032:analysis; D002908:Chronic Disease; D004487:Edema / Q000209:etiology; D005260:Female; D005506:Food Contamination; D006790:Host-Parasite Interactions; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D017747:Seafood; D013270:Stomach / Q000469:parasitology / Q000473:pathology
D000871:Anthelmintics; D000909:Antibodies, Helminth; D007074:Immunoglobulin G; D015766:Albendazole