Neurognathostomiasis, a neglected parasitosis of the central nervous system

Emerg Infect Dis. 2011 Jul;17(7):1174-80. doi: 10.3201/eid1707.101433.

Abstract

Gnathostomiasis is a foodborne zoonotic helminthic infection caused by the third-stage larvae of Gnathostoma spp. nematodes. The most severe manifestation involves infection of the central nervous system, neurognathostomiasis. Although gnathostomiasis is endemic to Asia and Latin America, almost all neurognathostomiasis cases are reported from Thailand. Despite high rates of illness and death, neurognathostomiasis has received less attention than the more common cutaneous form of gnathostomiasis, possibly because of the apparent geographic confinement of the neurologic infection to 1 country. Recently, however, the disease has been reported in returned travelers in Europe. We reviewed the English-language literature on neurognathostomiasis and analyzed epidemiology and geographic distribution, mode of central nervous system invasion, pathophysiology, clinical features, neuroimaging data, and treatment options. On the basis of epidemiologic data, clinical signs, neuroimaging, and laboratory findings, we propose diagnostic criteria for neurognathostomiasis.

MeSH terms

  • Adult
  • Albendazole / administration & dosage
  • Albendazole / therapeutic use*
  • Animals
  • Anthelmintics / administration & dosage
  • Anthelmintics / therapeutic use
  • Antibodies, Helminth / analysis
  • Central Nervous System / parasitology*
  • Central Nervous System / pathology
  • Enzyme-Linked Immunosorbent Assay
  • Europe
  • Foodborne Diseases / diagnosis*
  • Foodborne Diseases / drug therapy
  • Foodborne Diseases / epidemiology
  • Foodborne Diseases / mortality
  • Foodborne Diseases / parasitology
  • Foodborne Diseases / pathology
  • Gnathostoma / drug effects
  • Gnathostoma / physiology
  • Gnathostomiasis / diagnosis*
  • Gnathostomiasis / drug therapy
  • Gnathostomiasis / epidemiology
  • Gnathostomiasis / mortality
  • Gnathostomiasis / parasitology
  • Gnathostomiasis / pathology
  • Gnathostomiasis / transmission
  • Humans
  • Larva / drug effects
  • Larva / physiology
  • Magnetic Resonance Imaging
  • Neglected Diseases / diagnosis*
  • Neglected Diseases / drug therapy
  • Neglected Diseases / epidemiology
  • Neglected Diseases / mortality
  • Neglected Diseases / parasitology
  • Neglected Diseases / pathology
  • Nervous System Diseases / diagnosis*
  • Nervous System Diseases / drug therapy
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / mortality
  • Nervous System Diseases / parasitology
  • Nervous System Diseases / pathology
  • Survival Rate
  • Thailand

Substances

  • Anthelmintics
  • Antibodies, Helminth
  • Albendazole