Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Gnathostomiasis
Question: I'm looking for a US doctor that knows how to diagnose and treat Gnathostomiasis. General Practioners (MDs) and ER docs know nothing about it. I can't find a lab in the US that will run a serological test for gnathostomiasis (24 kDa immunoblot test. Please help
XXXXX
XXXXX
Brief Answer:
Your State lab CDC & Jewish Hospital in XXXXXXX Albendazole 400 BIDx7Day
Detailed Answer:
Welcome to HCM. Sorry for the lingering trouble. The lab work for the gnathostomiasis involves;
1. a CBC which looks for elevation on Eosinophils, this is not specific but if elevated this indicates that you do have a parasitic infection.
2. Your blood may also oshow elevated WBC/leukocytosis, when considered with high eosinophils then the probability increased to assume diagnosis.
3. ELISA (Enzyme-linked immunosoporbent assay) and Western blot testing to the parasite can be obtained, but this is not widely available in the US and even in other countries out of the US.
The 3 places to check would be your local state lab which would consult with the CDC, then there is National Jewish Health very good at research and we would send the weird lab requests and they would have reagents to run the tests, and of course Mayo has quite the broad experience with off the path diseases and infections.
4. If you have CNS/brain involvement, then a lumbar puncture will be the best way to delineate the presence.
5. If muscle involvement is there, and or other solid organ involvement, then biopsy will reveal the actual larvae.
Treatment:
========
1. Albendazole is very effective against helminths/parasites and mites in the body, however, your dose should not have been a one tine 400mg dose. You need at least 400mg twice a day for 7 days minimum, this ensures that the unhatched larvae are eradicated, and most patients will need another dose in 3 months. Imagine if one parasite survived in the body, you would want to re-test and its much easier to take another dose to treat what I call tail end infection.
2. Ivermectin is another option that can be tried in the event that you feel Albendazole did not work.
Re-infection:
=========
Hygiene is of paramount importance, even after treatment, one does not want to reinfect themselves as the cycle begins again. Cook all foods well, sushi and raw/undercooked meats are culprits, and of course when travelling to endemic areas use only bottled and boiled water.
I hope this helps you out, please ask more questions and we can assist as needed. Thanks and good luck.
Your State lab CDC & Jewish Hospital in XXXXXXX Albendazole 400 BIDx7Day
Detailed Answer:
Welcome to HCM. Sorry for the lingering trouble. The lab work for the gnathostomiasis involves;
1. a CBC which looks for elevation on Eosinophils, this is not specific but if elevated this indicates that you do have a parasitic infection.
2. Your blood may also oshow elevated WBC/leukocytosis, when considered with high eosinophils then the probability increased to assume diagnosis.
3. ELISA (Enzyme-linked immunosoporbent assay) and Western blot testing to the parasite can be obtained, but this is not widely available in the US and even in other countries out of the US.
The 3 places to check would be your local state lab which would consult with the CDC, then there is National Jewish Health very good at research and we would send the weird lab requests and they would have reagents to run the tests, and of course Mayo has quite the broad experience with off the path diseases and infections.
4. If you have CNS/brain involvement, then a lumbar puncture will be the best way to delineate the presence.
5. If muscle involvement is there, and or other solid organ involvement, then biopsy will reveal the actual larvae.
Treatment:
========
1. Albendazole is very effective against helminths/parasites and mites in the body, however, your dose should not have been a one tine 400mg dose. You need at least 400mg twice a day for 7 days minimum, this ensures that the unhatched larvae are eradicated, and most patients will need another dose in 3 months. Imagine if one parasite survived in the body, you would want to re-test and its much easier to take another dose to treat what I call tail end infection.
2. Ivermectin is another option that can be tried in the event that you feel Albendazole did not work.
Re-infection:
=========
Hygiene is of paramount importance, even after treatment, one does not want to reinfect themselves as the cycle begins again. Cook all foods well, sushi and raw/undercooked meats are culprits, and of course when travelling to endemic areas use only bottled and boiled water.
I hope this helps you out, please ask more questions and we can assist as needed. Thanks and good luck.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
