Clinical manifestations and immunodiagnosis of Gnathostomiasis in Culiacan, Mexico

Gnathostomiasis was first described in Mexico in 1970, and endemic areas ha ve been spreading in six states of this country. In Culiacan, Sinaloa, 300 cases of cutaneous larva migrans were recorded between January 1992 and Dec ember 1995. In addition, a Gnathostoma larva was surgically removed from th e eye of one patient. Cutaneous lesions were observed mainly on the face, n eck, arms, and legs. About 70% of the patients showed eosinophilia. A skin biopsy was carried out on 35 patients and the parasite was identified in hi stopathologic sections of 12 of these patients. In four patients, the larva migrated out spontaneously from the skin. An enzyme-linked immunosorbent a ssay using a crude somatic extract of adult Gnathostoma doloresi worms show ed that 93% of the patients were seropositive, confirming the reliability o f clinical diagnosis. A total of 14 advanced third-stage Gnathostoma larvae were found in four species of ichthyophagous birds captured on dams and di kes near the city of Culiacan. Scanning electron micrographs of human and b ird larvae showed that they were morphologically indistinguishable from G. spinigerum. We conclude that the life cycle of Gnathostoma has been establi shed in Sinaloa, and has become a serious public health issue for residents .