A person who ingests larvae of the Anisakis, Pseudoterranova or related genera may develop gastrointestinal symptoms that can be quite distressing.
The patient will often give a history of eating raw or poorly cooked fish or squid.
Syndromes determined by site of larvae movement and/or penetration:
(1) acute epigastric pain with gastric penetration
(2) acute abdominal pain with intestinal penetration
(3) chronic abdominal pain
(4) oropharyngeal irritation ("tingling throat")
Clinical and laboratory findings:
(1) nausea and vomiting
(2) low grade GI bleeding
(3) allergic reaction (if previously sensitized) with pruritus or urticaria
(4) mild eosinophilia
(5) positive serologic tests (which may be hard to find)
The larvae may be observed on endoscopy, can be coughed up or may be vomited up.
Endoscopic ultrasonography can identify gastric thickening with inflammation in the submucosa.
A biopsy may show a granulomatous reaction with eosinophils. A larva may or may not be found.
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Specialty: Infectious Diseases