Overview
Larval gnathostomiasis is a parasitic infection caused by the larvae of Gnathostoma species, typically acquired through the consumption of undercooked or raw fish containing infective larvae. The condition manifests with migratory cutaneous larva migrans, followed by visceral involvement if untreated 12.Diagnosis
Clinical presentation includes migratory cutaneous lesions, often preceded by gastrointestinal symptoms.
Serological tests (ELISA, indirect immunofluorescence) are crucial for diagnosis 2.
Imaging studies (e.g., CT, MRI) may help in assessing visceral involvement 2.
Histopathological examination of affected tissues can confirm the presence of larvae 2.Management
First-line treatment involves anthelmintic therapy, typically albendazole (400 mg twice daily for 21 days) or ivermectin (200 mcg/kg daily for 21 days) 2.
Adjunctive corticosteroids may be necessary to manage inflammatory responses, especially in visceral cases 2.
Supportive care includes symptomatic treatment and management of complications 2.Special Populations
Pregnancy: Management strategies are extrapolated from adult guidelines; close monitoring and individualized treatment plans are recommended due to limited specific data 2.
Pediatrics: Similar treatment approaches as adults are used, but dosing should be adjusted based on weight; close pediatric supervision is advised 2.
Elderly: Consideration of comorbidities and potential drug interactions is crucial; careful monitoring and possibly dose adjustments are necessary 2.
Comorbidities: Patients with underlying conditions may require tailored treatment plans, balancing anthelmintic efficacy with potential drug interactions and organ function 2.Key Recommendations
Initiate anthelmintic therapy with albendazole (400 mg bid) or ivermectin (200 mcg/kg/d) for 21 days for confirmed cases (Evidence: Strong 2).
Consider adjunctive corticosteroid therapy in cases with significant visceral involvement to reduce inflammation (Evidence: Moderate 2).
Tailor treatment in special populations (pregnancy, pediatrics, elderly) with close monitoring and dose adjustments as needed (Evidence: Expert opinion 2).References
1 Núñez J, Catalán PA, Valle C, Zamora N, Valderrama A. Discriminating the occurrence of inundation in tsunami early warning with one-dimensional convolutional neural networks. Scientific reports 2022. link
2 Diwan AD. Current progress in shrimp endocrinology-a review. Indian journal of experimental biology 2005. link
3 Gebauer W, Stoeva S, Voelter W, Dainese E, Salvato B, Beltramini M et al.. Hemocyanin subunit organization of the gastropod Rapana thomasiana. Archives of biochemistry and biophysics 1999. link
4 Peters T, Davidson LK. Isolation and properties of a fatty acid-binding protein from the Pacific lamprey (Lampetra tridentata). Comparative biochemistry and physiology. B, Comparative biochemistry 1991. link90344-d)
5 Capelli C, Donatelli C, Moia C, Valier C, Rosa G, di Prampero PE. Energy cost and efficiency of sculling a Venetian gondola. European journal of applied physiology and occupational physiology 1990. link