Case reports, case series, epidemiological investigations, and laboratory studies were reviewed; high-risk behaviors for gnathostomiasis were identified, and human cases of gnathostomiasis were stratified as cutaneous gnathostomiasis, visceral gnathostomiasis, neurognathostomiasis, and ocular gnathostomiasis.
6) Nine patients presented with cutaneous gnathostomiasis, two with visceral (gastrointestinal) gnathostomiasis, and two with signs of neurognathostomiasis.
5) Ultimately, one or more larvae may reemerge seeking to mature in any tissue and causing cutaneous, visceral, ocular, or neurognathostomiasis, or any combination of larva migrans.
3,12) These same mechanisms are also responsible for the four clinical manifestations of gnathostomiasis: (1) cutaneous disease with intermittent migratory swellings and, less often, subcutaneous nodules containing an L3 larva; (2) visceral (hepatic) or gastrointestinal disease; (3) neurognathostomiasis with high case fatality rates; and (4) ocular gnathostomiasis, the rarest manifestation of the larval migration.
3) The main clinical and diagnostic imaging features of neurognathostomiasis are compared in Table 2 and are also accompanied by peripheral hypereosinophilia.
Although gnathostomiasis is endemic to Asia and Latin America, almost all neurognathostomiasis cases are reported from Thailand.
We found 24 reports describing a total of 248 patients with neurognathostomiasis published in English-language literature.
With the advance of high-resolution neuroimaging, the parasitic tracks of Gnathostoma could be demonstrated on magnetic resonance imaging (MRI), aiding the diagnosis of neurognathostomiasis in the absence of worm recovery (11).
Most (241/248) identified cases of neurognathostomiasis reported in the English-language literature were from Thailand.
The first case of neurognathostomiasis in a traveler was reported in 2003 (19).