Title:
Invasive Gastric Anisakiasis. The Fisrt Confirmed Foodborne Parasitosis Case Report from Valencian Community (Spain).

Authors:
T. Llopis-Bañón, N. Moya-Hoyo, M.D. Jover-Ríos, J.C. López-Corbalán, J. Méndez-Mora, Á. Méndez-Jover, C. Seguí-Pérez, M. Seguí-Pérez, A. Pérez-Fullana, F. Caparrós-Hernández, V. Jordá-Climent, Elisabet Delgado-Sánchez, C. García-Cervera, V. Martínez-Sempere, J.M. Núñez Cruz, P. Esteve-Atiénzar and J.M. Seguí-Ripoll, Spain

Abstract:

Anisakiasis, in an environment like ours with high fish consumption, is an emerging zoonosis caused by the nematode of the Anisakidae family (Anisakis simple) acquired by ingesting raw or undercooked fish contaminated by larvae of the parasite. Being frequent in northern European countries and mainly in Japan, the incidence of reported cases in Spain (mainly the clinical forms of gastric presentation) is still low due to the low suspicion of diagnosis and the difficulty of performing an urgent gastroscopy in some hospitals. The clinical picture generally begins 5-7 hours after the ingestion of the suspicious fish (generally in our environment, raw or vinegar anchovies) with epigastric pain, nausea and vomiting (gastric anisakiasis), frequently accompanied by an allergic picture (angioedema, urticaria, anaphylaxis) in cases of intestinal anisakiasis. The clinical forms of gastric presentation have been little described in our setting (35 cases until 2016). To our knowledge, this is the first case of invasive gastric anisakiasis reported in the Valencian Community. Gastroscopy allows a diagnosis of certainty (possibility of direct visualization of free or partially embedded intragastric nematodes) and proceed to endoscopic extraction. Conclusion: In our setting, the history of recent ingestion of suspicious fish must be asked and investigated in patients with acute-onset digestive symptoms. Early gastroscopy is the technique of choice in gastric anisakiasis and allows the extraction of the larvae if it is visualized.