Case Report: The First Direct Evidence of Gnathostoma spinigerum Migration through Human Lung
| Autor: | Parnpen Viriyavejakul, Paron Dekumyoy, Kingpeth Promthong, Dorn Watthanakulpanich, Kittipong Chaisiri, Sumate Ampawong, Wallop Pakdee, Chaisith Sivakorn |
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| Rok vydání: | 2020 |
| Předmět: |
Gnathostomiasis
Gnathostoma Pathology medicine.medical_specialty Lung medicine.diagnostic_test biology business.industry Gnathostoma spinigerum medicine.disease biology.organism_classification Chronic infection Infectious Diseases medicine.anatomical_structure Intestinal mucosa Virology medicine Parasitology Lung cancer Chest radiograph business |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 103:1129-1134 |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.20-0236 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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