Anisakiasis Involving the Oral Mucosa

Anisakis is a parasite with life cycles involving fish and marine mammals. Human infection, anisakiasis, occurs with the ingestion of raw infected seafood and usually presents with acute or chronic gastrointestinal symptoms from esophageal or gastric invasion. We report a rare caseinvolving the oral cavity. A 39-year-old male presented with oral and sub-sternal pain of one day duration after eating raw cuttlefish. Physical examination revealed areas of erythema and edema with a central white foreign particle on the labial and buccal mucosa. With microscopic field we could remove the foreign material from the lesions. The foreign material was confirmed to be Anisakis. Anisakis was also removed from the esophagus by esophagogastroduodenoscopy. The patient was discharged the following day without complication. Anisakiasis is frequently reported in Korea and Japan, countries where raw seafood ingestion is popular. The symptoms of acute anisakiasis include pain, nausea, and vomiting and usually begin 2-12 hours after ingestion. The differential diagnosis includes food poisoning, acute gastritis, and acute pancreatitis. A history of raw seafood ingestion is important to the diagnosis of anisakiasis. Treatment is complete removal of the Anisakis to relieve acute symptoms and prevent chronic granulomatous inflammation.