Gnathostomiasis Follow-up

Updated: Apr 26, 2018
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

Most patients are treated on an outpatient basis, as the clinical circumstances dictate, except in cases with complications or CNS involvement.

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Further Inpatient Care

The need for inpatient care of patients with gnathostomiasis depends on the clinical presentation of the infection.

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Transfer

The need for transfer depends on the availability of necessary services and specialists.

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Deterrence/Prevention

The USFDA recommends the following for fish preparation or storage to kill parasites:

  • Cooking: Cook fish adequately (to an internal temperature of at least 145° F [~63° C]).
  • Freezing: At -4°F (-20°C) or below for 7 days (total time), or -31°F (-35°C) or below until solid, and storing at -31°F (-35°C) or below for 15 hours, or -31°F (-35°C) or below until solid and storing at -4°F (-20°C) or below for 24 hours.

In addition:

  • Emphasize the need to avoid exposure.

  • Ingestion of raw and undercooked food should be avoided in endemic areas.

  • Marinating fish/meat in vinegar for 6 hours or in soy sauce for 12 hours kills the larvae.

  • Marinating in lime juice does not kill the larvae, even with prolonged exposure.

  • Contaminated water should be boiled for 5 minutes before use.

  • Proper food handling practices: Gloves should be worn or the hands should be washed frequently if exposure to possibly contaminated water or flesh is likely.

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Complications

See the list below:

  • In Thailand, 6% of subarachnoid hemorrhages in adults and 18% of those in infants and children are due to gnathostomiasis.

  • Pneumonia, sepsis, paralysis, and/or long-term neurologic sequelae are possible.

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Prognosis

See the list below:

  • Gnathostomiasis is seldom fatal, except in cases of CNS disease.

  • Long-term morbidity is possible because of tissue injury during migration.

  • With CNS disease, the mortality rate is 8-25%; one third of survivors have long-term sequelae.

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