Anisakis
Background
- Parasitic disease caused by anisakid nematodes
- Larvae ingested via undercooked fish or squid
- Worms invade stomach or intestinal walls
Anisakid in a herring
Clinical Features
- Abdominal pain/distension, nausea/vomiting, bloody/mucus diarrhea
- Invasion of GI walls can cause peritonitis, appendicitis, SBO
- Mild fever
- Allergic-type reactions (e.g. rash, pruritus) including anaphylaxis can occur
Differential Diagnosis
Cestodes (Tapeworms)
- Taenia saginata
- Taenia solium (Cysticercosis)
- Diphyllobothrium latum
- Hymenolepis nana
- Echinococcus granulosus
Trematodes (Flukes)
- Fasciola hepatica
- Fasciolopsis buski
- Opistorchis viverrini
- Schistosoma spp
- Chlonorchis sinensis
- Paragonimus spp.
Nematodes (Roundworms)
- Ascaris lumbricoides
- Enterobius vermicularis (Pinworm)
- Filarial worms
- Loa Loa
- Onchocerciasis
- Lymphatic filariasis (Elephantiasis)
- Wuchereria bancrofti
- Brugia malayi
- Brugia timori
- Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
- Dracunculus medinensis
- Strongyloides stercoralis
- Trichuris trichiura (Whipworm)
- Anisakis
- Toxocara spp.
- Trichinosis
Evaluation
- Evaluate for alternate diagnoses
- Definitive diagnosis made by visualizing worms on endoscopy
Management
- Endoscopic or surgical removal of worms
- Albendazole 400mg PO BID x 6-21d
Disposition
- Dependant on severity of presentation
See Also
External Links
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