Case Report: Clinical Features of Intermittent Migratory Swelling Caused by Gnathostomiasis with Complete Follow-up

Abstract

A 15-year-old Thai girl was referred to the Hospital for Tropical Diseases of Mahidol University with a 3-week history of an intermittent migratory mass on the forehead. She was diagnosed with cutaneous gnathostomiasis. The patient was treated with albendazoleat 400 mg orally twice a day for 3 weeks, with good compliance. She revisited the hospital after 3 months and was seen to have been unresponsive to the initial treatment. There was intermittent swelling in her right upper eyelid along with mild redness around her right upper and lower eyelids. Another attempt of treatment was made with ivermectin 0.2 mg/kg/day for two consecutive days. This is a case of gnathostomiasis in full sequence, with complete follow-up. The case report starts from the beginning of the symptoms until the antibodies against Gnathostoma spinigerum decline to negative, confirmed by the western blot test. It took around 18 months to see the western blot test change to a negative result. The resolved clinical symptoms were possibly due to the responsiveness of the patient to ivermectin or the albendazole and ivermectin combination or even the coadministration of antibiotics afterward.