title: Cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia: a case report from China.
abstract: The present study reports a human case of cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia in China. A 52-year-old woman from Henan Province, central China, presented with recurrent migratory reddish swelling and subcutaneous nodule in the left upper arm and on the back for 3 months. Blood examination showed eosinophila (21.2%), and anti-sparganum antibodies were positive. Skin biopsy of the lesion and histopathological examinations revealed dermal infiltrates of eosinophils but did not show any parasites. Thus, the patient was first diagnosed as sparganosis; however, new migratory swellings occurred after treatment with praziquantel for 3 days. On further inquiring, she recalled having eaten undercooked eels and specific antibodies to the larvae of Gnathostoma spinigerum were detected. The patient was definitely diagnosed as cutaneous gnathostomiasis caused by Gnathostoma sp. and treated with albendazole (1,000 mg/day) for 15 days, and the subsequent papule and blister developed after the treatment. After 1 month, laboratory findings indicated a reduced eosinophil count (3.3%). At her final follow-up 18 months later, the patient had no further symptoms and anti-Gnathostoma antibodies became negative. Conclusively, the present study is the first report on a human case of cutaneous gnathostomiasis in Henan Province, China, based on the past history (eating undercooked eels), clinical manifestations (migratory subcutaneous nodule and persistent eosinophilia), and a serological finding (positive for specific anti-Gnathostoma antibodies).
authors.affiliation: Department of Parasitology, Medical College, Zhengzhou University, Zhengzhou 450052, Henan Province, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cui
authors.forename: Ye
authors.initials: Y
authors.lastname: Wang
authors.forename: Zhong Quan
authors.initials: ZQ
authors.lastname: Wang
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000276:immunology; D002681:China; D004802:Eosinophilia / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology*; D005260:Female; D006039:Gnathostoma / Q000276:immunology / Q000302:isolation & purification*; D058429:Gnathostomiasis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology*; D006801:Humans; D008875:Middle Aged; D012876:Skin Diseases, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000469:parasitology*
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth
keywords: China; Gnathostoma spinigerum; albendazole; gnathostomiasis; migratory subcutaneous nodule; serodiagnosis
references.citation: Korean J Parasitol. 2012 Jun;50(2):113-8
references.pmid: 22711921
references.citation: J Am Acad Dermatol. 2013 Feb;68(2):301-5
references.pmid: 22940406
references.citation: Clin Exp Dermatol. 2011 Dec;36(8):878-81
references.pmid: 21689146
references.citation: Clin Microbiol Rev. 2009 Jul;22(3):484-92
references.pmid: 19597010
references.citation: Korean J Parasitol. 2012 Mar;50(1):73-8
references.pmid: 22451738
references.citation: Am J Dermatopathol. 2004 Apr;26(2):91-5
references.pmid: 15024188
references.citation: Southeast Asian J Trop Med Public Health. 1991 Dec;22 Suppl:217-9
references.pmid: 1822889
references.citation: Korean J Parasitol. 1993 Dec;31(4):347-52
references.pmid: 8297892
references.citation: Trans R Soc Trop Med Hyg. 1992 Jul-Aug;86(4):418-21
references.pmid: 1440822
references.citation: Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2012 Feb 29;30(1):71-2
references.pmid: 22913197
references.citation: Am J Trop Med Hyg. 2009 Feb;80(2):185-7
references.pmid: 19190210
references.citation: Parasitol Int. 2010 Dec;59(4):599-605
references.pmid: 20804856
references.citation: Emerg Infect Dis. 2012 Dec;18(12):2087-9
references.pmid: 23171480
references.citation: Korean J Parasitol. 2010 Sep;48(3):259-61
references.pmid: 20877507
references.citation: Am J Trop Med Hyg. 2012 Jun;86(6):988-92
references.pmid: 22665606
references.citation: J Helminthol. 2013 Sep;87(3):257-70
references.pmid: 23046708
references.citation: Parasitol Res. 2011 Jun;108(6):1551-6
references.pmid: 21181193
references.citation: Southeast Asian J Trop Med Public Health. 1991 Dec;22(4):611-7
references.pmid: 1820651
references.citation: Int J Parasitol. 1991 Jun;21(3):315-9
references.pmid: 1894429