Gnathostomiasis nach Aufenthalt in Thailand.

During a 4-week holiday in Thailand a 13-year-old boy from Germany
briefly fell ill with diarrhoea without blood-tinged stools and
fever. 5 months later oedematous, reddish swellings occurred, at
first on the right upper arm, later over the right side of the
chest. Especially at night these swellings were associated with
severe local and generalized itching. Bilaterally the axillary
lymph-nodes were hard and slightly enlarged. There was a marked
eosinophilia of 56%, the white count was 22,700/microliters and the
serum level of IgE was raised to 1777 IU/ml. No worm eggs or larvae
were found in the stool. Enzyme-linked immunosorbent assay, using
larvae of Gnathostoma spinigerum as antigen, demonstrated
antibodies against this nematode. Gnathostomiasis having been
diagnosed treatment was started with albendazole (200 mg twice
daily for 21 days), after which the boy was symptom free. After 2
months the eosinophilia had regressed to 10%, the white cell count
was normal and the antibody titre had fallen.