Cutaneous gnathostomiasis in a woman from Bangladesh

A woman from Bangladesh who had lived in Germany for more than 2 years presented with migratory, painful swellings on her left hand and arm of 5 months duration. Laboratory examinations yielded a marked eosinophilia and a grossly elevated IgE level in combination with an inflammatory reaction restricted to the subcutaneous tissues. A preliminary diagnosis of gnathostomiasis was established and confirmed by a positive gnathostoma serology by enzyme immunoassay (EIA). Treatment was initiated with albendazole, leading to the outward migration of a larva and complete resolution of clinical disease. Currently, there is no definitive therapy that has been proved to be both safe and highly effective. A wide range of potential agents has been used in clinical studies, but only albendazole has proved to be reliably effective to date, stimulating the outward migration of larvae in a proportion of cases of cutaneous disease, as observed in the present case.