SHM Converge Scientific Abstract ePoster Gallery-Help! Up Came a Worm! A Case of Anisakiasis

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This case describes anisakiasis, a rare parasitic infection caused by Anisakis nematode larvae acquired from raw or undercooked seafood. Humans are accidental hosts, so the worm cannot complete its life cycle in the body. Infection is most common in regions with high raw fish consumption, such as Japan, parts of South America, and Northern Europe, and is uncommon in the United States.<br /><br />A previously healthy 19-year-old college student presented after coughing up a live worm. The night before, he had developed an unusual cough and right-sided chest cramping, along with a sensation that something was stuck in his throat. He also had concurrent COVID-19 symptoms, but these respiratory complaints were distinct from his usual illness. Two days earlier, he had eaten raw salmon sushi. He had no gastrointestinal or urinary symptoms, no worms in stool, and no concerning exposure history otherwise. Physical exam and laboratory studies were normal. The worm’s morphology was consistent with Anisakis. He was observed for 24 hours and discharged without complications.<br /><br />Anisakiasis is usually self-limited because larvae do not survive long in humans. Symptoms typically appear within hours after ingestion and may include acute abdominal pain, irritation, bowel obstruction, or allergic reactions such as rash, itching, or anaphylaxis. If the larvae invade the bowel, a delayed eosinophilic granulomatous reaction can cause bloody or mucoid diarrhea, vomiting, abdominal pain, and even perforation.<br /><br />Diagnosis is made by identifying the worm, usually via endoscopy, surgery, or, in rare cases like this one, regurgitation. Eosinophilia may be absent. First-line treatment is removal of the worm; albendazole may sometimes be used. Prevention depends on properly cooking or freezing seafood according to FDA recommendations.

Asset Subtitle

Alan Aung

Meta Tag

Author List Alan Aung, Amanda Nguyen, Haya Najjar, Kenton Smitherman

Category Clinical Vignettes

Concept Anisakis

Concept Anisakiasis

Concept Worm removal

Concept Raw seafood

Concept Undercooked seafood

Distinguished Finalist

Presenter Organization University of California, San Diego

Presenting Author Alan Aung

Track Adult

Keywords

anisakiasis

Anisakis

parasitic infection

raw seafood

raw salmon sushi

nematode larvae

coughing up worm

eosinophilic granulomatous reaction

endoscopic diagnosis

FDA seafood freezing

Anisakis

Anisakiasis

Worm removal

Raw seafood

Undercooked seafood