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      Gnathostomiasis Acquired by British Tourists in Botswana

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          Abstract

          Infection with Gnathostoma spinigerum has been generally confined to Southeast Asia and Central and South America. However, gnathostomiasis was recently found in British tourists who had visited Botswana. Consequently, travel to Africa should now be considered a risk factor for gnathostomiasis.

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          Most cited references13

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          Gnathostomiasis: An Emerging Imported Disease

          As the scope of international travel expands, an increasing number of travelers are coming into contact with helminthic parasites rarely seen outside the tropics. As a result, the occurrence of Gnathostoma spinigerum infection leading to the clinical syndrome gnathostomiasis is increasing. In areas where Gnathostoma is not endemic, few clinicians are familiar with this disease. To highlight this underdiagnosed parasitic infection, we describe a case series of patients with gnathostomiasis who were treated during a 12-month period at the Hospital for Tropical Diseases, London.
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            Clinical gnathostomiasis: case report and review of the English-language literature.

            Human gnathostomiasis is most frequently caused by the nematode Gnathostoma spinigerum. This disease is endemic to Southeast Asia, particularly Thailand and Japan. The clinical presentation is most commonly characterized by localized, intermittent, migratory swellings of the skin and subcutaneous tissues, often in association with localized pain, pruritus, and erythema. Since this worm can migrate to deeper tissues, any organ system may become involved. Characteristically, patients with gnathostomiasis have a moderate to severe elevation of the peripheral eosinophil count, with values not uncommonly exceeding 50% of the total white blood cell count. With modern-day travel and immigration, cases of gnathostomiasis are being diagnosed with increased frequency in the United States. Because of its rarity in this country, however, gnathostomiasis often is not included in an initial differential diagnosis despite the characteristic triad of intermittent migratory swelling, a history of travel to Southeast Asia, and eosinophilia. We report a case of cutaneous gnathostomiasis diagnosed in the United States, and we present a clinical review of the English-language literature on human gnathostomiasis.
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              Comparison of ivermectin and albendazole treatment for gnathostomiasis.

              Comparative treatment of ivermectin in 21 patients (Group 1) and albendazole in 49 patients (Group 2) of gnathostomiasis gave the cure at 95.2% and 93.8% respectively. The ELISA OD and eosinophil counts were reduction after treatment. Side effects in ivermectin were hypotention, dizziness, weakness and diuresis; and side effects of albendazole were nausia, dizziness and increased alkaline phosphatase in two cases. Ivermectin should be an effective drug againts gnathostomiasis and more convenient in treatment single dose.
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                Author and article information

                Journal
                Emerg Infect Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                April 2009
                : 15
                : 4
                : 594-597
                Affiliations
                [1]Hospital for Tropical Diseases, London, UK (J.S. Herman, E.C. Wall, C. van Tulleken, P. Godfrey-Faussett, R.L. Bailey, P.L. Chiodini)
                [2]London School of Hygiene and Tropical Medicine, London (P. Godfrey-Faussett, R.L. Bailey, P.L. Chiodini)
                Author notes
                Address for correspondence: Joanna S. Herman, Department of Clinical Parasitology, Hospital for Tropical Diseases, 3rd Floor, Mortimer Market, Capper St, London WC1E 6JB, UK; email: joherman@ 123456doctors.org.uk
                Article
                08-1646
                10.3201/1504.081646
                2671435
                19331741
                f8b72427-8f82-404c-92c9-2b13001df803
                History
                Categories
                Dispatch

                Infectious disease & Microbiology
                gnathostomiasis,bream,ivermectin,albendazole,tourists,dispatch,botswana,gnathostoma sp.,eosinophilia,united kingdom

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