Comparative Parasitology 67(1) 2000 - Peru State College
Comparative Parasitology 67(1) 2000 - Peru State College
Comparative Parasitology 67(1) 2000 - Peru State College
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74 COMPARATIVE PARASITOLOGY, <strong>67</strong>(1), JANUARY <strong>2000</strong><br />
6-yr-old Indian girl from Oman, Arabian Peninsula<br />
(Bhargava et al., 1996), and extragastrointestinal<br />
"anisakidosis" has been reported<br />
in the mucous membrane of pharynx and<br />
esophagus in Japan (Ishikura et al., 1993); the<br />
identity of these worms was not elaborated<br />
further.<br />
We attribute the upper gastrointestinal invasiveness<br />
of the larva of P. decipiens through the<br />
unusual esophageal site to the immune depression<br />
of the patient or weakness from ALS. The<br />
continued penetration of the worm through the<br />
neck tissue and the exiting through the neck sore<br />
represent an extreme case of invasiveness that,<br />
to the best of our knowledge, has not been previously<br />
reported in larvae of either Anisakis or<br />
Pseudoterranova.<br />
We believe that the state of the patient could<br />
have been related to 1 or more of the following<br />
3 factors: ALS, Lyme disease, or anisakid(s).<br />
Symptoms of anisakiasis may persist after worm<br />
death because some lesions have been found<br />
upon surgical removal that contain only nematode<br />
remnants. Stenosis of the pyloric sphincter<br />
was observed in a case where exploratory laparotomy<br />
had revealed a worm that was not removed<br />
(FDA/CSFAN, 1992). Simultaneous<br />
multiple infections with as many as 10 anisakid<br />
worms have been reported in Japan (Ishikura et<br />
al., 1993). Although acute necrotizing eosinophilic<br />
granulomatous inflammation involving the<br />
intestine has been documented in cases of invasive<br />
anisakiasis, hypersensitivity, sensitization,<br />
and a chronic form of the disease lasting<br />
about 2 yr have also been documented (Pinkus<br />
et al., 1975; Alonso et al., 1997).<br />
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