Rusnak J M, Lucey D R
Department of Infectious Diseases, Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas 78236-5300.
Clin Infect Dis. 1993 Jan;16(1):33-50. doi: 10.1093/clinids/16.1.33.
Human gnathostomiasis is most frequently caused by the nematode Gnathostoma spinigerum. This disease is endemic to Southeast Asia, particularly Thailand and Japan. The clinical presentation is most commonly characterized by localized, intermittent, migratory swellings of the skin and subcutaneous tissues, often in association with localized pain, pruritus, and erythema. Since this worm can migrate to deeper tissues, any organ system may become involved. Characteristically, patients with gnathostomiasis have a moderate to severe elevation of the peripheral eosinophil count, with values not uncommonly exceeding 50% of the total white blood cell count. With modern-day travel and immigration, cases of gnathostomiasis are being diagnosed with increased frequency in the United States. Because of its rarity in this country, however, gnathostomiasis often is not included in an initial differential diagnosis despite the characteristic triad of intermittent migratory swelling, a history of travel to Southeast Asia, and eosinophilia. We report a case of cutaneous gnathostomiasis diagnosed in the United States, and we present a clinical review of the English-language literature on human gnathostomiasis.
人类颚口线虫病最常见的病因是棘颚口线虫。这种疾病在东南亚地区流行，尤其是泰国和日本。临床表现最常见的特征是皮肤和皮下组织出现局部性、间歇性、游走性肿胀，常伴有局部疼痛、瘙痒和红斑。由于这种蠕虫可迁移至更深层组织，任何器官系统都可能受累。典型的是，颚口线虫病患者外周血嗜酸性粒细胞计数中度至重度升高，其值常超过白细胞总数的50%。随着现代旅行和移民的增加，美国颚口线虫病的诊断病例越来越多。然而，由于该病在该国较为罕见，尽管存在间歇性游走性肿胀、有前往东南亚旅行史和嗜酸性粒细胞增多这一典型三联征，但在初步鉴别诊断中往往不包括颚口线虫病。我们报告了一例在美国诊断出的皮肤颚口线虫病病例，并对关于人类颚口线虫病的英文文献进行了临床综述。
