Gnathostomiasis Follow-up

Updated: Apr 26, 2018
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Further Outpatient Care

Most patients are treated on an outpatient basis, as the clinical circumstances dictate, except in cases with complications or CNS involvement.


Further Inpatient Care

The need for inpatient care of patients with gnathostomiasis depends on the clinical presentation of the infection.



The need for transfer depends on the availability of necessary services and specialists.



The USFDA recommends the following for fish preparation or storage to kill parasites:

  • Cooking: Cook fish adequately (to an internal temperature of at least 145° F [~63° C]).
  • Freezing: At -4°F (-20°C) or below for 7 days (total time), or -31°F (-35°C) or below until solid, and storing at -31°F (-35°C) or below for 15 hours, or -31°F (-35°C) or below until solid and storing at -4°F (-20°C) or below for 24 hours.

In addition:

  • Emphasize the need to avoid exposure.

  • Ingestion of raw and undercooked food should be avoided in endemic areas.

  • Marinating fish/meat in vinegar for 6 hours or in soy sauce for 12 hours kills the larvae.

  • Marinating in lime juice does not kill the larvae, even with prolonged exposure.

  • Contaminated water should be boiled for 5 minutes before use.

  • Proper food handling practices: Gloves should be worn or the hands should be washed frequently if exposure to possibly contaminated water or flesh is likely.



See the list below:

  • In Thailand, 6% of subarachnoid hemorrhages in adults and 18% of those in infants and children are due to gnathostomiasis.

  • Pneumonia, sepsis, paralysis, and/or long-term neurologic sequelae are possible.



See the list below:

  • Gnathostomiasis is seldom fatal, except in cases of CNS disease.

  • Long-term morbidity is possible because of tissue injury during migration.

  • With CNS disease, the mortality rate is 8-25%; one third of survivors have long-term sequelae.