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Case Report: The First Direct Evidence of Gnathostoma spinigerum Migration through Human Lung.
Am J Trop Med Hyg. 2020 Jun 22 [Online ahead of print]AJ

Abstract

Gnathostomiasis is a helminthic infection caused by the third-stage larvae of nematodes of the genus Gnathostoma. The life cycle in humans starts with an enteric phase, with the worm perforating the gastric or intestinal mucosa to reach the peritoneal cavity and migrating through the human body. Subsequent penetration through the diaphragm may produce pleuropulmonary symptoms. We herein present a previously healthy 56-year-old Thai man from Southern Thailand who was an ex-smoker presented with chronic dry cough progressing to hemoptysis after consuming grilled swamp eels and freshwater fish. Chest computed tomography showed consolidation at the lingular segment, and the differential diagnosis was primary lung cancer and pulmonary tuberculosis. The lung tissue biopsied during bronchoscopy displayed segments of organisms with the phenotypic characteristics of Gnathostoma spp., and abundant eosinophils were seen in the alveolar tissue. Gnathostoma spinigerum infection was confirmed by a Western blot assay for G. spinigerum-specific 24-kDa reactive band. The patient received albendazole, and a follow-up chest radiograph revealed improvement in the consolidation in the lung and reduction in hemoptysis. We report the first direct evidence including pathology and immunohistochemistry of Gnathostoma invasion via the human lung, with clinical and radiographic presentations mimicking either malignancy or chronic infection.

Authors+Show Affiliations

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Pulmonary and Critical Care Medicine, Maharaj Nakhon Si Thammarat Hospital, Thailand.Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32588815

Citation

Sivakorn, Chaisith, et al. "Case Report: the First Direct Evidence of Gnathostoma Spinigerum Migration Through Human Lung." The American Journal of Tropical Medicine and Hygiene, 2020.
Sivakorn C, Promthong K, Dekumyoy P, et al. Case Report: The First Direct Evidence of Gnathostoma spinigerum Migration through Human Lung. Am J Trop Med Hyg. 2020.
Sivakorn, C., Promthong, K., Dekumyoy, P., Viriyavejakul, P., Ampawong, S., Pakdee, W., Chaisiri, K., & Watthanakulpanich, D. (2020). Case Report: The First Direct Evidence of Gnathostoma spinigerum Migration through Human Lung. The American Journal of Tropical Medicine and Hygiene. https://doi.org/10.4269/ajtmh.20-0236
Sivakorn C, et al. Case Report: the First Direct Evidence of Gnathostoma Spinigerum Migration Through Human Lung. Am J Trop Med Hyg. 2020 Jun 22; PubMed PMID: 32588815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case Report: The First Direct Evidence of Gnathostoma spinigerum Migration through Human Lung. AU - Sivakorn,Chaisith, AU - Promthong,Kingpeth, AU - Dekumyoy,Paron, AU - Viriyavejakul,Parnpen, AU - Ampawong,Sumate, AU - Pakdee,Wallop, AU - Chaisiri,Kittipong, AU - Watthanakulpanich,Dorn, Y1 - 2020/06/22/ PY - 2020/6/27/entrez JF - The American journal of tropical medicine and hygiene JO - Am. J. Trop. Med. Hyg. N2 - Gnathostomiasis is a helminthic infection caused by the third-stage larvae of nematodes of the genus Gnathostoma. The life cycle in humans starts with an enteric phase, with the worm perforating the gastric or intestinal mucosa to reach the peritoneal cavity and migrating through the human body. Subsequent penetration through the diaphragm may produce pleuropulmonary symptoms. We herein present a previously healthy 56-year-old Thai man from Southern Thailand who was an ex-smoker presented with chronic dry cough progressing to hemoptysis after consuming grilled swamp eels and freshwater fish. Chest computed tomography showed consolidation at the lingular segment, and the differential diagnosis was primary lung cancer and pulmonary tuberculosis. The lung tissue biopsied during bronchoscopy displayed segments of organisms with the phenotypic characteristics of Gnathostoma spp., and abundant eosinophils were seen in the alveolar tissue. Gnathostoma spinigerum infection was confirmed by a Western blot assay for G. spinigerum-specific 24-kDa reactive band. The patient received albendazole, and a follow-up chest radiograph revealed improvement in the consolidation in the lung and reduction in hemoptysis. We report the first direct evidence including pathology and immunohistochemistry of Gnathostoma invasion via the human lung, with clinical and radiographic presentations mimicking either malignancy or chronic infection. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/32588815/Case_Report:_The_First_Direct_Evidence_of_Gnathostoma_spinigerum_Migration_through_Human_Lung L2 - http://www.ajtmh.org/content/journals/10.4269/ajtmh.20-0236?crawler=true&mimetype=application/pdf DB - PRIME DP - Unbound Medicine ER -
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