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Abstract: Gnathostomiasis is a parasitic infection caused by the third larval stage of nematodes of the genus Gnathostoma. The disease is endemic in some countries around the world. In the American continent, the majority of cases is concentrated in Mexico, Ecuador, and Peru. However, due to increasing traveling either at the intercontinental or intracontinental level, the disease is seen each time more frequently in tourists. Furthermore, countries, such as Brazil, that have never been considered endemic are reporting autochthonous cases. The disease usually presents as a deep-seated or slightly superficial migratory nodule in patients with history of eating raw fish, in the form of ceviche, sushi, or sashimi. Along with the clinical presentation, diagnostic criteria include either blood or tissue eosinophilia. In most instances, these criteria are enough for the attending physician to institute therapy. Chances of finding the parasite are low, unless the biopsy is taken from a very specific area that develops after antiparasitic treatment is started. The potential of other organ involvement with more serious consequences should always be kept in mind.

Abstract The genus Gnathostoma comprises 17 species, whose adult specimens are found in the stomach serosa of animals that consume raw fish; some species of the genus are zoonotic agents. The present study describes the presence of a nematode (Gnathostomatidae) parasitizing the digestive tract of Colomesus psittacus in the Ilha de Marajó in the eastern Brazilian Amazon. Thirty specimens of C. psittacus were collected in the municipality of Soure, Ilha de Marajó, state of Pará, Brazil, transported to the laboratory, necropsied and the helminths were collected and fixed. Of the 30 fish that were studied, 16.67% were parasitized with nematodes. The nematode larvae found encysted in the intestinal serosa have anterior region with two lips, each with a pair of papillae; a cephalic bulb armed with six rows of discontinuous spines; four cervical sacs; a claviform esophagus; cuticular striations along the body; a simple excretory pore; and a short tail ending in a mucron. These morphological structures are diagnostic characters of the genus Gnathostoma, whose adults parasitize the stomach of carnivorous mammals and, rarely, the stomach of fish. However, fish, amphibians, reptiles, and birds are intermediate hosts of the third-stage larvae (L3), and humans may act as accidental hosts.

A gnatostomíase é parasitose endêmica em alguns países asiáticos, causada pela ingestão da larva do nematódio Gnathostoma sp, que pode ocorrer no consumo de carne crua de peixes de água doce. Atinge vários órgãos, entre eles a pele, manifestando-se frequentemente como lesão subcutânea migratória. Países da América Central e do Sul como México e Peru vêm apresentando número crescente de casos da doença desde 1970. Este trabalho registra o primeiro caso notificado e publicado no Brasil e alerta para o surgimento dessa doença em áreas anteriormente não endêmicas. Relata-se caso de paciente, com história de viagem ao Peru, que evoluiu com quadro cutâneo compatível com gnatostomíase.Gnathostomiasis is an endemic disease in Asian countries caused by the ingestion of larval stage of Gnathostoma sp roundworms that may be acquired by eating raw fresh-water fish. It can reach many organs and the skin is one of them, characterized by creeping eruptions and/or migrating erythema. Since 1970 the number of patients affected seems to be increasing in Central and South America countries like Mexico and Peru. This is the first notification and publication of gnathostomiasis in Brazil, and it serves as an alert to the possibility of the emergence of this disease in non-endemic areas. We report a case of a man who traveled to Peru and developed cutaneous features accordant with gnathostomiasis.

Gnathostomiasis is an endemic disease in Asian countries caused by the ingestion of larval stage of Gnathostoma sp roundworms that may be acquired by eating raw fresh-water fish. It can reach many organs and the skin is one of them, characterized by creeping eruptions and/or migrating erythema. Since 1970 the number of patients affected seems to be increasing in Central and South America countries like Mexico and Peru. This is the first notification and publication of gnathostomiasis in Brazil, and it serves as an alert to the possibility of the emergence of this disease in non-endemic areas. We report a case of a man who traveled to Peru and developed cutaneous features accordant with gnathostomiasis.