Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 35-28: Gnathostomiasis + Key Features Download Section PDF Listen +++ ++ Infection caused by eating undercooked fish, shellfish, chicken, pork Can also be transmitted by ingesting copepods in contaminated water After ingestion, larvae cannot complete development in humans, but rather migrate through tissues Infection is most common in southeast Asia but has been described in many other areas + Clinical Findings Download Section PDF Listen +++ ++ Acute gastrointestinal symptoms Include nausea, vomiting, abdominal pain, and fever May develop soon after infection and persist for 2–3 weeks The disease may then progress to findings consistent with cutaneous or visceral larva migrans Migratory subcutaneous erythematous swellings may be painful or pruritic Migrating larvae may also invade other tissues, leading to findings in the eyes, lungs, intestines, and elsewhere Most serious complications are due to invasion of the CNS, leading to eosinophilic meningoencephalitis and other serious findings Severe pain due to migration through spinal roots and focal neurologic findings may be seen CSF eosinophilic pleocytosis and peripheral eosinophilia are seen + Diagnosis Download Section PDF Listen +++ ++ Diagnosis is suggested by history of intermittent subcutaneous swellings and typical CNS findings Worms can occasionally be identified in skin lesions Serologic tests may be helpful + Treatment Download Section PDF Listen +++ ++ Ivermectin, 200 mcg/kg single oral dose, or albendazole, 400 mg/kg orally daily for 21 days However, indications for treatment are uncertain with CNS disease because inflammatory responses to dying worms might worsen outcomes; corticosteroids may be indicated with antihelminthics in these cases