Frey, Simon, Kuenzli, Esther, Henning, Lars, Bravo, Francisco, Nawa, Yukifumi, and Neumayr, Andreas (2026) Human gnathostomiasis – A systematic review and analysis of the literature. PLoS Neglected Tropical Diseases, 20 (7). e0014546.

Preview

PDF (Published Version) - Published Version Available under License Creative Commons Attribution. Download (2MB) | Preview

Abstract

Human gnathostomiasis is a foodborne zoonotic nematode infection caused by the larval stage of Gnathostoma species. Although historically reported predominantly from Asia and America, cases are increasingly identified in previously non-endemic regions. The heterogeneous clinical presentation and diagnostic challenges likely contribute to underrecognition of the global disease burden. Current evidence is largely derived from case reports and case series, with a notable lack of prospective studies. To better delineate the epidemiological distribution and clinical characteristics of human gnathostomiasis, we systematically reviewed and analyzed the available literature. Most cases are reported from Asia and the Americas, with Thailand, Japan, and Mexico accounting for the highest numbers. Clinical manifestations are predominantly larva migrans syndromes, including cutaneous involvement (83.6% of cases), followed by neurological (7.7%), ocular (3.5%), and visceral (2.3%) presentations. Long-term sequelae are uncommon overall but occur frequently in ocular (51.8%) and neurological (32.2%) disease, the latter also being associated with a substantial case-fatality rate (33.9%). Diagnosis is based on exposure risk, most commonly consumption of raw fish (70.7%), as well as laboratory findings such as eosinophilia, positive serology, and, when feasible, histopathological confirmation. Treatment primarily relies on anthelmintic treatment with albendazole and/or ivermectin and, if feasible, surgical removal of larvae. Treatment success is highest with albendazole plus ivermectin combination therapy (86.7%) compared to monotherapy with albendazole (73.5%) or ivermectin (56.7%).

Item ID:	94532
Item Type:	Article (Research - C1)
ISSN:	1935-2735
Copyright Information:	Copyright: © 2026 Frey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Date Deposited:	02 Nov 2026 04:57
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3207 Medical microbiology > 320704 Medical parasitology @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 60% 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 20% 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 20%
	More Statistics