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 Nawa
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.
