Gongylonema pulchrum Symptoms, Causes, Treatment

Gongylonema pulchrum is a parasite nematode of the genus Gongylonema that infects humans, causes inflammation and palpable mass on the affected site. Gullet worm or stitch worm are other names of this worm. It is found in mammals and birds, in arthropods like beetle dung and cockroaches are intermediate vectors of this parasite. It is hard to diagnose. It remains in the buccal cavity in humans, but in other animals, it spreads down the gastrointestinal tract. Infection is caused due to accidental exposure of humans to the parasite. It is forbidden to drink water that does not boil and should use adequately washed and cooked vegetables and meat to prevent exposure. 

What is Gongylonema pulchrum?

A stitch worm is a thin thread-like worm, and it has no circulatory and respiratory system. Size depends on the host, from where it arises. It is only a few millimetres long and moveable into the mucosal lining. Humans from any age and gender can become a victim of Gongylonema. A lump or inflammatory mass in the oral cavity was observed initially. There are seven genera of spirudia nematodes that infect human hosts accidentally: gnathostome, thelazia, gongylonema, physaloptera, spirocerca, rictularia. The Gongylonema pulchrum parasite is a nematode worm of the order Spirurida. In the Gongylonema family, it is the only species that can infect humans. Most other gongylonema species infect birds and mammals. Based on microscopic and morphologic examination of the pathogen, it confirmed that it is a nematode.

Gongylonema pulchrum Symptoms, Causes, Treatment

Symptoms may not appear when the worm is in the larva stage, and it requires several weeks for the development into adult worms. Once noted, symptoms may continue from a month to a year if the worm is not surgically extracted. And get resolved upon removal of parasites. It can be treated quickly. The patient’s symptoms resolved immediately after removing the pathogen and showed no scar upon healing, the extracted specimens from the mouth helped in the morphological examination of Gongylonema species.

Stool specimens also perform additional analysis. But infectious stages are hard to determine in laboratory diagnosis. Some physicians can’t recognize it as Gongylonemiasis because of its rarity; the transient nature of the symptoms leads to misdiagnosed it as parasitoses or oral candidiasis. No abnormalities in haematological investigations with or without elevated eosinophil counts. Insects, Hedgehogs, rabbits, dogs, cattle, and cats serve as the host for the Gongylonema nematodes. In humans, its life cycle continues at the time of exposure to the parasite. It lays eggs in the mouth cavity, develops and matures into adult worms, and keeps moving around into the mouth of a human. 

Gongylonema pulchrum Symptoms

Like other diseases and infections, Gongylonema pulchrum infection starts with mild signs and symptoms and proceeds towards severity over time if not treated and may last up to weeks to years. Initially, body temperature rises, and patients may feel flu, nausea, and dizziness even before identifying the worm. Most of the patients complain of Gongylonema, the moving itchy sensation in their mouth’s mucosal areas that are soft palate, inner cheeks, gums, tongue, even on lips. Other symptoms are stomatitis, palpable mass.

Luckily, in humans, this parasite won’t spread down the oesophagus as it does in animals. Sometimes, patients may pull-out the worms from their mouth ulcers by using their fine needles or even with their fingers because worms may protrude from the mass lesions. Symptoms include a sense of inflammation and ulceration at the site of infection. Rarely, gastrointestinal pain is also reported in some patients. In most identified cases of human disease with Gongylonema pulchrum, clinical signs include local irritation of the oral mucosa as well as occasional blood expectoration, tarry stools, numbness of the tongue, pain in the chest and abdomen, vomiting, bloating, pharyngitis, burning mouth syndrome, and even psychosis.

Gongylonema pulchrum Causes

The Source of the infection is unknown. But it is considered that it gets into the human due to poor sanitary habits. Contamination of food by infected dung beetles and cockroaches or by the direct consummation of infected insects. Accidental or intentional usage of contaminated water. The buccal mucosa is the ideal environment for the Gongylonema species, and it grows in the mouth. 

Gongylonema pulchrum Treatment

Treatment is required to get relief from the symptoms. In some cases, symptoms resolve themselves for a short period. A surgical extraction is the recommended treatment for the noticed worm by using local anesthetics during surgery. After surgery, no scar has been seen at the place of the ulcer. The periodic checkup is recommended as a post-surgical follow-up and anthelmintic class drug albendazole to stop developing the parasite eggs into adult ones. 

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