Autochthonous Gnathostomiasis, Brazil – Emerging Infectious Diseases

A 37-year-old man from Rio de Janeiro sought medical attention in 2005 because of low fever, cough, abdominal tenderness, and pain in the left shoulder. The symptoms started 15 days after a recreational trip to Tocantins, where he practiced sport fishing and ate sashimi-style freshwater raw fish (Cichla sp.) that had just been caught. He reported no history of traveling to a gnathostomiasis-endemic area. Initial work-up depicted eosinophilia (43%), and a computed tomographic scan of the chest revealed left pleural effusion. Two weeks later, winding, linear, reddish lesions appeared on his back, which lasted 3 days. Serologic testing forSchistosoma mansoni was weakly positive. Acute schistosomiasis was diagnosed, and treatment with praziquantel was begun. In 4 weeks, all symptoms faded.