[Gnathostomosis, an exotic disease increasingly imported into Western countries]

AN INCIDENTAL HELMITHIASIS IN MAN: Gnathostomiasis is an helminthic disease of animals due to a nematode belonging to the gender Gnathostoma. This gender includes many species, the most frequent being Gnathostoma spinigerum. Man is an incidental host. Human gnathostomiasis is endemic in some countries of South-East Asia, and Latin America. It is due to the consumption of raw or insufficiently cooked meat or fish. Since the beginning of the eighties, there is an increasing number of cases of gnathostomiasis described in Western countries in travellers returning from endemic countries. IN THE SKIN OR THE VISCERA: Gnathostomiasis is a cause of cutaneous and/or visceral larva migrans syndrome. Some visceral involvement, more particularly neurological forms, may lead to significant morbidity and mortality. The diagnosis is occasionally confirmed by the identification of the Gnathostoma larva in the skin or viscera. Most often the diagnosis relies on epidemiological, clinical and biological (hypereosinophilia, positive serologic test) grounds. ALBENDAZOLE AND IVERMECTINE: The first line treatment is albendazole, 400 mg once or twice a day during 21 days. The efficacy of ivermectin needs to be assessed more precisely. Relapses may occur up to 24 months after apparent cure.