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Volume 17, Number 7—July 2011

CME ACTIVITY

Neurognathostomiasis, a Neglected Parasitosis of the Central Nervous System

Juri Katchanov, Kittisak Sawanyawisuth, Verajit Chotmongkol, and Yukifumi NawaComments to Author 
Author affiliations: Author affiliations: Mahidol University, Bangkok, Thailand (J. Katchanov, Y. Nawa); Khon Kaen University, Khon Kaen, Thailand (K. Sawanyawisuth, V. Chotmongkol)

Main Article

Table 3

Proposed diagnostic criteria for neurognathostomiasis*

Epidemiologic criteria
Travel or residence in the disease-endemic area
AND exposure to undercooked freshwater fish, frogs, poultry,
and shellfish
Clinical syndrome
Painful radiculomyelitis/radiculomyeloencephalitis
OR meningitis/meningoencephalitis
OR intracerebral hemorrhage
OR subarachnoid hemorrhage
Indirect evidence of CNS invasion
CSF studies: eosinophilic pleocytosis
OR neuroimaging: parenchymal hemorrhagic tracks (>3 mm)
Immunodiagnosis
Positive detection of reactivity against the 24-kDa component
of Gnathostoma spinigerum in immunoblot test†
Absence of reactivity against the 29–31-kDa components of
Angiostrongylus cantonensis in immunoblot test

*All criteria should be fullfiled for clinical diagnosis of neurognathostomiasis. CNS, central nervous system; CSF, cerebrospinal fluid.
†If negative, a follow-up examination 4 weeks later is recommended.

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