This is a 63-year-old mestizo, born in Medellín and residing in Bogotá, who had recently traveled to the United States.
He had a history of epilepsy with absence seizures treated properly; he did not smoke and his alcohol consumption was occasional.
Days before admission due to a clinical picture of 15 days of evolution with intense abdominal pain "difficult to describe" frequency (acute onset and epigastric region), sleep interruption, hypoxia and decreased urinary
The patient associated the onset of symptoms with tap water intake at home.
The previous week she had consulted the emergency room on four occasions for the same reason.
At the time of admission, the patient was in good general condition, hydrated, with blood pressure of 123/74 mm Hg, heart rate of 75 beats per minute, respiratory rate of 16 per minute, normal auscultation neck temperature 37 or C.
The patient was hospitalized and underwent paraclinical evaluations with the following results: leukocytes: 8,120 per mm 3, neutrophils: 59.4 %, lymphocytes: 16.0 %, eosinophils: 18.6 %, hemoglobin: 17.4 g/dl, normal platelets: 27 %
At plain radiography, ultrasonography, abdominal magnetic resonance imaging and endoscopic retrograde cholangiopancreatography no abnormalities were observed.
Upper gastrointestinal endoscopy revealed a hiatal hernia with Schatzki ring and edematous and antral mucosa with some erosions.
Biopsy revealed chronic active gastritis, while endoscopy of the lower digestive tract revealed no abnormalities.
During hospitalization, the patient developed several panic attacks, agitation and anxiety, in addition to exacerbation of abdominal pain, requiring medical and pharmacological psychiatric management.
On the sixth day of hospitalization, a 2 x 2 cm erythematous area appeared in the right abdominal flank, which appeared in a migratory pattern bepentine and aX extended to describe a midline "and advanced" similar.
A skin biopsy was taken at the site where the lesion began. Histopathological study showed epidermal detachment and a large amount of perivascular and interstitial eosinophils.
A week after the appearance of the lesion, a careful manual examination was performed and, when the lesion was stopped, an area raised in the right flank was found, from which a low mineral oil 8 mm was extracted.
1.
The examination of lax was performed underneath the optic disc. It showed a glus composed of a bulb and a corpus. The bulb was filled with a bulb, identifying the long epithelium and zygosine with a single intestine.
This feature allowed us to identify the specimen as belonging to the genus Florida in the United States, where the patient consumed foods prepared with fish and shellfish; although it is clear that the geographical area described is not endemic to Ecuador China exe
Taxonomic identification is based on certain morphological characteristics of the home (17), including the shape of the body, including the number of rows of hair cells (17), and the intestinal segment of the body that lies between the layers.
Host flushes allow the larvae to open the path between host tissues and produce mechanical tissue damage and symptoms.
Identification of the species is useful from an epidemiological point of view, since the treatment is the same for all species (3.5).
Clinical characteristics can occur in immediate symptoms after infection and cutaneous or visceral symptoms, as appropriate.
Between 24 and 48 hours after ingestion, the individual may present general malaise, fever, anorexia, nausea, vomiting, diarrhea and abdominal pain, which may be diffuse, epigastric or right upper quadrant.
Gnathostoma and as the most probable species to G. spinrum, the diagnosis of cutaneous gnathostomiasis was confirmed.
The patient was treated with 200 mg of albendazole daily for 18 days and satisfactorily recovered.
