Sushi, ceviche and gnathostomiasis - A case report and review of imported infections

We describe a case of imported cutaneous gnathostomiasis in a Thai patient living in France. Gnathostomiasis is a zoonosis of food origin. The disease is endemic in Southeast Asia and Latin America. However, over the past 30 years, an increasing number of imported cases has been described in Europe and America. The disease is rare in Western Europe and the majority of cases described had a cutaneous clinical presentation. The disease may sometimes be confused with allergy, leading to a delay in diagnosis. Visceral symptoms are rare but may follow severe attacks. A definitive diagnosis can be obtained by the isolation of larvae from skin biopsies, but these are rarely performed. The diagnosis is usually presumptive, based on a combination of anamnestic, clinical, and biological factors. Several courses of the anti-helminths, albendazole or ivermectin, are often necessary. Although rare, the diagnosis should be evoked systematically in a migrant or traveller returning from an endemic area with cutaneous lesions.