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In this review, epidemiological features, diagnosis, and treatment processes of Gongylonema pulchrum cases were discussed. G. pulchrum is a spiruroid nematode usually seen in ruminants; it is known to occasionally infect humans. In humans, reports revealed that it is usually located in the oral cavity and that the most common symptom is the sensation of a moving foreign body in the mouth. Although there is no proven treatment approach yet, it is thought that the most effective treatment is surgery. After surgical treatment, it has been observed that albendazole is administered as the drug therapy in almost all cases. Although the conflict about the benefit of albendazole continues, it is claimed that the drug controls the disease and prevents its recurrence. It has been reported that clinicians sometimes experience difficulties in differential diagnosis due to a lack of knowledge and experience on this rare parasite. A better understanding of the etiopathogenesis of Gongylonema infections will facilitate the diagnosis and treatment of this infection.

Draschia megastoma, Habronema microstoma, and Habronema muscae are the etiological agents of cutaneous habronemosis, commonly known as summer sores, an inflammatory cutaneous and ocular parasitic disease of horses and other equids transmitted by flies. Here, we describe a cluster of cutaneous habronemosis in five horses that showed single or multiple typical cutaneous ulcerative wounds located on the face, lower forelegs or hindquarters in Israel with the presence of typical "sulphur granules." All affected animals were confirmed by histopathological and/or molecular methods to be infected by H. muscae. This constitutes the first report of cutaneous habronemosis in Israel in which the causative nematode, H. muscae, was identified by molecular means. Cutaneous habronemosis should be considered as a differential diagnosis in equids with cutaneous ulcerative lesions during the summer months, especially when affected animals are refractive to antibiotic treatment alone., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Nematodes of the genus Gongylonema infect a wide range of mammals worldwide but are only sporadically reported in humans. We describe a case of human infection with Gongylonema pulchrum in a 41-year-old man. The patient extracted the nematode from the submucosa under his tongue and correctly self-diagnosed the infection with the help of the Google search engine. In the laboratory, the collected nematode was confirmed as G. pulchrum microscopically by morphological analysis and genetically by amplifying and sequencing the parasite's rDNA. This is the first report of human G. pulchrum infection in Slovenia.

Habronemosis is a common parasitic disease of horses worldwide. In order to investigate how haptoglobin (Hp), serum amyloid A (SAA), oxidative stress markers, nitric oxide (NO), interleukin-6 (IL-6) and tumor necrosis factor (TNF- α), varies in cutaneous habronemosis, 30 horses with the clinical disease and 20 clinically healthy horses were included in the current study. The serum levels of Hp, SAA, and proinflammatory cytokines (IL-6 and TNF-α), NO, malondialdehyde (MDA), super oxide dismutase (SOD), glutathione (GSH), and total antioxidant capacity (TAC) were determined in horses before and after two weeks of treatment. The serum levels of Hp, SAA, IL-6, TNF-α and MDA were significantly elevated in infected horses as compared to the controls. Alternately, the serum levels of SOD, GSH, TAC and NO, were recorded low in infected horses as compared to the controls. All tested markers resumed the same levels after treatment as in control group. The Hp, SAA, IL-6, TNF-α, and MDA exhibited a high degree of clinical accuracy of the cases diagnosis. The area under the curve (AUC) for acute phase proteins (SAA, Hp), IL-6, TNF-α, and MDA was 0.87, 0.94, 0.96, 0.96 and 1.0, respectively. These findings showed that Hp, SAA, IL-6, TNF-α, and MDA may be supportive in the diagnosis of cutaneous habronemosis in horses and, simultaneously, they can also be used to monitor the progress of the treatment., (Copyright © 2018 Elsevier B.V. All rights reserved.)

AbstractWe describe a case of human infection with Gongylonema pulchrum acquired in southeast Georgia. The patient presented with intermittent yet persistent nausea and vomiting for months. This case describes the need for extraction of worms on two occasions each followed by courses of albendazole treatment. Gongylonema pulchrum infections with high worm burden may relapse after extraction of the worm and a 3-day short course of albendazole therapy. Longer courses of albendazole may be indicated in selected circumstances.

Background: Although long known, infestations of the buccal mucosa by nematodes of the Gongylonema genus are rare, particularly in France. Herein we report a new case., Patients and Methods: A 48-year old man consulted for itching in various parts of the buccal mucosa over the preceding weeks. The patient lived in a rural region in southern Alsace and had never visited Africa. His work comprised overseeing the unloading of flour at the port of Basel. The initial clinical examination was negative. However, the patient managed to photograph a filament previously present in his buccal mucosa, and to ultimately extract a worm. The latter was identified at the Strasbourg Institute of Parasitology by Pr Pesson as a nematode of the genus Gongylonema sp. pulchrum. No other treatment was considered necessary., Discussion: It is important for dermatologists to be aware of this type of parasitosis. Its stereotyped clinical presentation allows ready diagnosis, but the possible absence of the parasite at the time of the visit may lead to a misdiagnosis of Ekbom syndrome (delusional parasitic infestation)., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Gongylonema spp. are cosmopolitan spirurid nematodes that are common parasites of wild and domesticated mammals and birds. Gongylonema pulchrum Molin, 1857 is most common in ruminants, where it invades mucosa and submucosa of the mouth, tongue, oesophagus and forestomachs. It extremely rarely occurs in man, and fewer than 60 cases have been reported worldwide. We report a case from the Alsace region, which appears to be the first case of human gongylonemosis described in France., (© B. Pesson et al., published by EDP Sciences, 2013.)

We report a rare parasitic nematode infection in a 26-year-old healthy African American man. Gongylonema nematode infections in humans are unique in their ability to localize in the submucosa of the oral cavity and oropharynx. Humans are incidental hosts for the Gongylonema nematode, which is more commonly found in rudimentary animals, birds, and rodents. Approximately 50 cases of human Gongylonema infections have been reported worldwide, including 11 documented cases in the United States.(1) The pathogenesis, characteristic clinic findings, and identification features will be discussed.

Equine cutaneous habronemosis, also known as "summer sores", is a parasitic infection caused by larvae of Habronema microstoma and Habronema muscae (Nematoda, Spirurida) released by dung-inhabiting fly vectors on abraded skin, skin wounds or muco-cutaneous transition sites. Larvae induce a local inflammatory reaction characterised by itching, granulomatous, ulcerated and, often non-healing, lesions. The diagnosis of summer sores may be unreliable mainly because of the limits of clinical and microscopic examination. The applicability of a semi-nested PCR assay developed for the diagnosis of gastric habronemosis has been herein demonstrated for the detection of the cutaneous infection. The potential applicability of this diagnostic tool may have for clinical and epidemiological studies of cutaneous habronemosis in equids is discussed.

Numerous cases of Gongylonema spp. infection with associated pathological lesions and clinical signs were identified in a collection of Goeldi's monkeys (Callimico goeldii) (GMs) at a zoological park during a 3-yr period. An increase in the incidence of clinical signs in the GMs and other callitrichid species prompted an investigation to determine the prevalence of infection within the collection and evaluate treatment protocols. Twenty-one callitrichids [nine GMs, four golden lion tamarins (Leontopithecus rosalia), six cotton-top tamarins (Saguinus oedipus), and two golden-headed lion tamarins (Leontopithecus chrysomelas)] were included in this study. Many of the animals had been positively diagnosed on past examinations. Repeated cytological evaluations of scrapings taken from the mucosa of the tongue were performed to diagnose infection. The animals were randomly divided into two groups and treated with either ivermectin (290 microg/kg p.o., q7 days for four doses) or mebendazole (70 mg/kg p.o. q24 hr for three doses). Follow-up scrapings were performed on all animals at days 35, 64, and 156. Numerous animals displayed clinical signs (facial pruritus, inflammation, and ptyalism) before and throughout the investigation; however, Gongylonema spp. infections were only confirmed by tongue scrapings in two animals. Fecal floatation by using a sodium nitrate solution for recovery of spirurid eggs also was performed, but it yielded no positive results. The low number of confirmed cases precluded comparative evaluation of the efficacy of the anthelmintic treatment protocols. However, both regimes seemed subjectively similar in decreasing clinical signs and were safe with no adverse effects. Diagnosis of Gongylonema spp. infection is challenging, even when severe clinical signs are present. This investigation further demonstrates the lack of a reliable ante-mortem test for the parasite and underscores the importance of treatment based on clinical signs. Until a more sensitive test is available, further comparison studies on treatment regimes will be difficult and likely unrewarding.

The first human infection with Gongylonema in Iran is reported in a 35-year-old Iranian woman with complaints of one year duration and treated as a psychotic patient. Two worms, a male, and a female, were retrieved, described, and identified as G. pulchrum based on their morphological characteristics.

Gastric habronemosis of horses caused by Habronema microstoma and Habronema muscae (Nematoda, Spirurida) is characterized by catarrhal gastritis, diarrhoea, progressive weight loss and ulcers. Despite its importance in the equine industry and in clinical practice, knowledge of the epidemiology of this infection is still incomplete as diagnosis in live animals is challenging. A two-step semi-nested PCR assay using ribosomal DNA (rDNA) markers has recently been used for the molecular diagnosis in vivo of gastric habronemosis based on the detection of H. microstoma and/or H. muscae DNA in equine faeces. To evaluate the field efficacy of this assay, a molecular epidemiological survey was carried out on equid gastric habronemosis in central Italy. One hundred and fifty-three individual faecal samples were collected from live native horses and subjected to both coprological examination and the two-step semi-nested PCR. When flotation procedures were performed no horse tested positive for Habronema spp. larvated eggs while 96 animals (61.2%) were positive for other endoparasites (i.e. strongyles, oxyurids, ascarids). Two-step semi-nested PCR detected 86 samples (53.6%) that were positive for H. microstoma and/or H. muscae DNA. H. microstoma prevalences showed statistically significant differences; the highest prevalence was observed in horses infected by other gastrointestinal parasites and concomitantly by H. muscae. No statistical differences were found between the prevalence of Habronema spp. infection and sex, age, breeding management, and antiparasitic treatments. This field survey provided further information on habronemosis and its epidemiology.

History: A 27-year-old woman repeatedly attended an outpatient clinic and reported sensations of movement within the buccal mucosa. Various local inspections were without any obvious abnormal findings. A few days later the patient brought a filiform structure, which she had extracted from the affected mucosa by manipulation with her toothbrush., Investigation: Microscopy indicated a gravid female nematode of the genus Gonglyonema., Diagnosis: Gonglyonem pulchrum infection., Treatment and Course: Careful inspection revealed a second worm at the other side of the oral cavity, which was extracted by local incision. After removal of the second worm the patient remained free of symptoms without any further therapy., Conclusion: Even obviously very unusual symptoms, which might be indicative of a dermatozoic delusion, should be carefully clarified. In some cases it may be appropriate to consult a specialized institutions or laboratory to rule out a possible parasitic infections.

This report describes the morphologic and histologic features of a case of esophageal Gongylonema pulchrum infection and esophageal squamous cell carcinoma in a 17-yr-old, female vari (Lemur macaco variegates). The lemur had lived in a German zoo and had a clinical history of dyspnea, vomiting, and anorexia. At necropsy, a whitish, soft, nodular, centrally necrotic mass was found in the caudal third of the esophagus. In addition, numerous intraepithelial nematodes (G. pulchrum) were observed in the entire esophagus. Results suggest a relation between infection with G. pulchrum and development of an esophageal squamous cell carcinoma.

Habronema microstoma and Habronema muscae (Spirurida: Habronematidae) are parasitic nematodes which infect the stomach and/or skin of equids. The accurate diagnosis of gastric habronemosis is central to studying its epidemiology, but data on its distribution and prevalence are lacking, mainly due to the limitations of clinical and coprological diagnosis in live horses. To overcome this constraint, a two-step, semi-nested PCR-based assay was validated (utilizing genetic markers in the nuclear ribosomal DNA) for the specific amplification of H. microstoma or H. muscae DNA from the faeces from horses (n = 46) whose gastrointestinal parasite status had been determined at autopsy and whose faeces were examined previously using a conventional parasitological approach. Of these horses examined at autopsy, some harboured adults of either H. microstoma (n= 19) or H. muscae (n =4), and others (n = 7) harboured both species. Most of them were also infected with other parasites, including strongylid nematodes (subfamilies Cyathostominae and Strongylinae), bots and/or cestodes; there was no evidence of metazoan parasites in 2 horses. Larvated spirurid eggs were detected in the faeces of 1 of the 30 horses (3.3 %) shown to be infected with Habronema at autopsy. For this set of 46 samples, the PCR assay achieved a diagnostic specificity of 100 % and a sensitivity of approximately 97 % (being able to specifically detect as little as approximately 0.02 fg of Habronema DNA). The specificity of the assay was also tested using a panel of control DNA samples representing horse, the gastric spirurid Draschia megastoma and 26 other species of parasites from the alimentary tract of the horse. H. microstoma, H. muscae and D. megastoma could be readily differentiated from one another based on the sizes of their specific amplicons in the PCR. The results of this study showed that the performance of the PCR for the diagnosis of gastric habronemosis was similar to that of autopsy but substantially better than the traditional coprological examination procedure used. The ability to specifically diagnose gastric habronemosis in equids should have important implications for investigating the epidemiology and ecology of H. microstoma and H. muscae.

A case of infection with Gongylonema is described in a 41-year-old woman living in New York City. The patient sought medical attention with the complaint of a sensation of 1-year duration of something moving in her mouth. On two occasions she removed worms from her mouth, once from her lip, once from the gum. One of the specimens submitted for examination was an adult female Gongylonema. It is not possible to say whether the infection was acquired in New York City, or elsewhere, since the patient traveled frequently to Mississippi to visit relatives. As cases of delusional parasitosis continue to increase, clinicians and laboratorians alike need to be alert to the possibility that foreign objects removed from the mouth, or elsewhere, may indeed represent unusual parasitic infections, and that these objects should be examined before being discarded.

Physaloptera infections were diagnosed endoscopically in 18 dogs. Each case had vomiting as the primary clinical sign, and four cases had regurgitation as a concurrent sign. Fecal flotations, using magnesium sulfate solution, were performed in 12 of the 18 cases and were negative for Physaloptera eggs. In 12 of the 18 cases, only one worm was seen during endoscopic examination. Fifteen of 18 cases were treated with pyrantel pamoate, and 10 of 12 cases with follow-up had resolution of their vomiting.

Two cases of gongylonematiasis in common marmosets of two research facilities in Germany are reported. The helminthiasis was transmitted from colony A to colony B by one infected female and within colony B by cockroaches (Blatella germanica). Four of 40 cockroaches examined in colony B were infected with rhabditiform larvae. Clinical signs of disease in the infected animals consisted of intense itching and scratching of the edematous and slightly hyperemic perioral tissues. Histologically the adult helminths lodged predominantly in the mucous membranes of the upper and lower lips; they were less frequently present in the labial cutaneous parts or in the tongue and could not be seen in the esophageal wall, bronchi, or abdominal organs. The helminthic infection probably caused minor to moderate mixed inflammatory infiltrates of the periesophageal connective tissues and intense inflammation of the deep lingual muscular tissues. Lesions of the mucosal membranes of the lips and tongue had predominant accumulations of neutrophilic granulocytes, lymphocytes, and mostly degranulated mast cells with only a few eosinophilic granulocytes. In the cutaneous part of the lips multifocal microabscesses were considered to be secondary lesions from the intense scratching.