Gongylonema pulchrum

Gongylonema pulchrum: Description, Causes and Risk Factors:

The gullet worm of cattle; a species that penetrates the submucosa of the esophagus or rumen of many domestic and wild ruminants, pigs, bears, and humans (human cases are chiefly caused by immature worms); it is transmitted by coprophagous beetles and is of Worldwide distribution.

gongylonema pulchrum

Gongylonema pulchrum is the species that has been identified as the cause of Gongylonema infection in humans. Infection caused by this species has been reported to occur in sheep, cattle, pigs, and other ungulates. The Life cycle of G. pulchrum requires an insect as the intermediate host. Fully embryonated eggs are passed in the feces of the aforementioned species and require ingestion by an appropriate insect host, such as a cockroach or a dung beetle. The parasite undergoes obligate development to the infective stage within the insect (20-30 days after ingestion), and infection of the definitive vertebrate host occurs after ingestion of the insect. Adult worms require some 60-80 days to develop in the definitive host after ingestion of an infected insect.

In humans, ingestion is typically accidental and unrecognized. None of the data from recorded cases of Gongylonema pulchrum infection have indicated that the infected patients had knowingly ingested insects. Although the Life cycle of Gongylonema pulchrum is well known, the factors that put some people at increased risk for infection with Gongylonema pulchrum are not clearly understood. It is plausible that the risk of eating insect-contaminated food is increased in areas where levels of sanitation are poor, including some areas visited by travelers. In some parts of the World and in some cultures, insects are an important source of protein and calories, and Gongylonema infection could potentially be a risk for those who eat uncooked insects. Presumably, a roasted or otherwise well-cooked insect would pose no risk of Gongylonema infection.

In humans, there can be an up to six week incubation period for worm development and symptoms may not appear until the second molting of the worm, in which the young adult worms begin migration to from the esophagus to the buccal and oral palate tissue. It is this movement through the mucosa of the mouth and lips that causes patients to complain of symptoms.

Gongylonema pulchrum infection of man is very rare, but to date, there have been nearly 50 cases in humans described Worldwide, including China, Europe, the Middle East, Australia and New Zealand.

Symptoms:

With initial infection, some patients have reported mild fever and flu-like symptoms. There are also reports of acute attack of nausea, vomiting, and dizziness.The most common symptom is the complaint of sensation of a something is moving around the mouth, near the lips, and in the soft palate area. Eosinophilia is noted in some patients.

Diagnosis:

Diagnosis is often made by visible recognition of the worm moving through the tissue of the buccal cavity by either patient or doctor. Also, recovery of worm from patient is also a diagnostic technique. Microscopic identification of worm removed from patient's mouth or tissue is another diagnostic technique for determining the parasite infection type.

Treatment:

Treatment with albendazole, a broad-spectrum anthelmintic, was initiated because of the concern that additional worms might still be present. There is no confirmed proof that treatment with albendazole or any other anthelmintic results in a cure in humans. However, because of the wide margin of safety associated with this drug and the possibility of additional worms being present, treatment seems to provide some advantages over no treatment. Treatment done by removal of worms either by use of the fingers or by use of a curette in a physician's office also be successful.

Follow up measures include periodic of checks of buccal cavity and esophagus to ensure parasite infection has cleared.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

27 Comments

  1. Teresa

    Hi I have the same symptons since returning from turkey 2 yrs ago u have actually seen it but don’t noabout getting a testrong as my dream won’t except worms parasites r really please advise

    Reply
    • editor-m

      Thank you for commenting. First of all, you need to do the proper diagnosis with a method you choose and then if approved take a medicine to get rid of worms. Please, contact your doctor for full explanation and help.

      Reply
  2. G Lee

    I live in west Africa and pulled a worm out of my mouth in July, and had my picture taken with it which helped my doctor identify it. I took a wormer but not as strong as what the few posts say to take. Now my doctor in the USA has recommended staying on the wormer longer than the typical 3 days dose of west Africa treatment. I have only had the one worm in my mouth but will take a more aggressive approach to not find any more.

    Reply
    • editor-m

      Thank you for sharing your story, G Lee. Hopefully, it will help others to avoid similar problems.

      Reply
  3. Louise benner

    I believe I have an invasion of this parasite. My thigh, nose, ears throat, eyes, cheeks , headed to my brain, it’s traveling upwards the neck,already on the scalp area. Possibly in my lungs, coughing badly now. Initially movement at night, now all the time throughout my body. Have had blood test done, fecal testing done ,all negative of parasites. Then WHT all the movement around mouth, nose, head back, all ove. Where can I get help. Who can I see

    Reply
    • editor-m

      There is a danger of misdiagnosing infections of G. pulchrum as delusional parasitosis.The best option for you is to see your GP, he will recommend you all the needed testing and will examine you carefully.We do not recommend you any kind of self-treatment.

      Reply
      • Suffering

        How do you obtain a correct diagnosis? I am in a country where doctors have never heard of this and can’t see it. I can feel movement, experience swelling partularly after eating and have verybstickyndischarge from gums with texture that changes. Albendazole did not work.

        Reply
        • maisteri

          Usually the parasites are visible. if not, other causes of your unusual sensations should be ruled out.

          Reply
        • Angela

          I have the same! Finally being treated with Albendazole 400 mg this thing Is huge since it’s been there for two years before being diagnosed! It’s nested everywhere even under my cheekbones and my eyes! What’s your current situation!

          Reply
    • Emily Day

      I dont even know how I ended up on here. Your story sounds like what I’m going through right now. I just witnessed black worm that looked like it had small white worms inside of it in the back of my throat popping in and out of the mucous with ease. 6 mo ths of being sick, I got a splenic artery aneurism and no clue why, I’m healthy 31 yr old. Please email me if by chance u see this and let me know what your issue turned out to be and treatment. I’m miserable. Close to the end. [email protected]

      Reply
      • maisteri

        Dear Emily,
        it is better for you to visit your GP and consult with him regarding this situation. If you really have any worms – this condition is completely treatable. Regarding the splenic artery aneurism – usually aneurisms are the inborn abnormalities of the vessels that may affect any artery of any person – and there is typically no explanation for this condition.

        Reply
  4. Linda Farrell

    Editor-m Sept 27, 2017 at 1:21

    I called my doctor & asked for some medicine as I was sure I had a parasite. (I had accually seen it, much like a tapeworm it jumped on and quickly went in to my skin. He gave me a couple scripts of ivermectin. I took the 1st and waited acouple weeks and almost nothing. Then I took the 2nd dose and gradually they died or so I though. Six weeks went by and they were back. On my tongue and the smooth parts of my mouth. I called him back and his secretary told me that he would not help with that and he thought I should see a psychiatrist. I do not understand where he gets that and I feel so helpless.

    Reply
    • maisteri

      To make a diagnosis and verify the type of the parasite the microscopic examination is recommended. However, you should be examined carefully. Try to make an appointment by an infectionist or at least another GP.
      If during the examination no parasites are found, consider a consultation of psychiatrist/psychotherapist.

      Reply
    • Angela

      Insist! It happened to me for 2 years until I called the CDC. My whole face is now infested! They nested under my cheekbones causing blurred vision eaten through my teeth and live underneath my tongue! They have driven me insane for two years. I finally found a doc familiar who is treating me with 400 mg of Albenzadole per day and I’m afraid it may be too late. I’ve received a referral to John Hopkins University hospital which is out of state because they believe they have traveled throughout my body into my throat lungs and other organs!!!
      I have been listed in pA as Delusional. ADVOCATE FOR YOURSELF!!!

      Reply
  5. Linda farrell

    Addition to last comment/ meant to say hookworm instead of tapeworm.

    Reply
  6. katie reed

    how large and how widespread can this parasite go in human body? is physically removing parasite the only way to eradicate them from body? I have this from head to toe. literally.

    Reply
    • maisteri

      The parasite typically remains in the oral cavity of humans, however, in animals, it may travel through the digestive and respiratory systems. Gongolynema may be up to 3 cm long. Yes, it should be physically removed and afterwards the 3-day course of albendazole is suggested, although the effectiveness of albendazole in this particular case is unknown.

      Reply
      • Jason Achilles

        Actullally the females reach up to 14 or 15 c at full maturity

        Reply
        • maisteri

          No, they are not so big. The average length is about 3 cm, the females sometimes may reach 7-8 cm, but not longer.

          Reply
  7. Bhavna

    Hi, please help me. I am from India and have the same symptoms but nobody is believing me.
    What should I do? I can’t seem to remove it physically. Where do I go?

    Reply
    • maisteri

      You should see a general practitioner or a surgeon as the parasite has to be removed by a healthcare professional.

      Reply
  8. Sue

    I am having difficulties with having what sounds like this parasite removed from my oral cavity after a trip to China. It appears to be a little deep to see easily although t times I have seen what appears to be the start of a worm but it moves away too quickly to remove myself. Is there any evidence that using medication will kill,live worms or just prevent additional ones.

    Reply
    • maisteri

      It is recommended to remove the worm surgically followed by the treatment with albendazole, hence, unfortunately, medications are not effective enough to kill the parasite.

      Reply
  9. Sue Blyde

    Do you have any information about the best way to remove this as what I have is quite deep and can be felt but difficult to see. Most likely picked up in China I think.

    Reply
    • maisteri

      Anyway you shouldn’t remove it by yourself, it is better to see a surgeon and let him take care of you.

      Reply
      • Sue

        They seem to have difficulty seeing it. Any idea how to bring them out to be clearly visible on the surface.

        Reply
        • maisteri

          Unfortunately there is no other way to make the worms visible – the oral mucosa should be carefully inspected and that’s it.

          Reply

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