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Case Report

Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases

Woon-Mok Sohn1,*, Byoung-Kuk Na1, Tae Hyo Kim2, Tae-Joon Park3
The Korean Journal of Parasitology 2015;53(4):465-470.
Published online: August 25, 2015

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* Corresponding author (wmsohn@gnu.ac.kr)
• Received: April 29, 2015   • Revised: May 21, 2015   • Accepted: June 16, 2015

© 2015, Korean Society for Parasitology and Tropical Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases
Korean J Parasitol. 2015;53(4):465-470.   Published online August 25, 2015
DOI: https://doi.org/10.3347/kjp.2015.53.4.465
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Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases
Korean J Parasitol. 2015;53(4):465-470.   Published online August 25, 2015
DOI: https://doi.org/10.3347/kjp.2015.53.4.465
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Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases
Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases
Case no. Age Sex Date of occurrence Fish eaten Chief complaints Time from eating fish to symptom onset Time from symptom onset to endoscopy Detection site of worm in stomach
1. 33 M Oct., ’99 Common conger Severe epigastric pain 12 hr 2 days Middle body G.Ca
2. 47 M Feb., ’00 Several kinds of marine fishes Epigastric pain, nausea & vomiting 12 hr 3 days Upper body Anterior wall
3. 37 M Jun., ’00 Common conger Hemoptysis 10 hr 1 day Lower body G.Ca
4. 27 M Jun., ’00 Several kinds of marine fishes Epigastric pain 12 hr 36 hr Upper body G.Ca
5. 41 M Aug., ’00 Several kinds of marine fishes Epigastric pain & nausea 24 hr 3 days Upper body G.Ca
6. 28 M Oct., ’00 Common conger Epigastric pain 6 hr 12 hr Middle body G.Ca
7. 55 M Jun., ’01 Several kinds of marine fishes Severe epigastric pain 12 hr 2 days Lower body G.Ca
8. 59 M Jan., ’02 Common conger Epigastric pain 12 hr 12 hr Middle body G.Ca
9. 45 F Sep., ’02 Common conger & Pacific cutlass fish Epigastric pain & hematemesis 6 hr 3 days Uncertainb
10. 36 F Oct., ’02 Several kinds of marine fishes Severe epigastric pain 12 hr 2 days Lower body G.Ca
11. 42 M Apr., ’03 Anchovy Epigastric pain, nausea & vomiting 10 hr 1 day Upper body Anterior wall
12. 51 M May., ’04 Common conger Severe epigastric pain 12 hr 1 day Uncertainb
13. 61 M Mar., ’09 Anchovy Epigastric pain, nausea & vomiting 10 hr 1 day Upper body lesser curvature
14. 52 M Dec., ’09 Uncertain Epigastric pain & nausea 7 hr 1 day Lower body G.Ca
15. 46 F Jan., ’10 Common conger Severe epigastric pain 12 hr 2 days Uncertain
Items 3rd stage (n = 7) 4th stage (n = 7) Chai et al. (1986) [7]b
Body length 16.55-29.0 (23.98) 17.10-22.75 (20.68) 13.4-25.0 (20.7)
Body width 0.35-0.58 (0.48) 0.45-0.58 (0.50) 0.23-0.54 (0.41)
Esophagus (total) 2.0-3.0 (2.46) 2.35-3.38 (2.88) 1.86-2.70 (2.36)
 Muscular part 1.55-2.08 (1.85) 1.75-2.50 (2.18) 1.27-1.89 (1.65)
 Ventricular part 0.45-0.92 (0.62) 0.55-0.88 (0.71) 0.57-0.83 (0.71)
Tail 0.08-0.12 (0.10) 0.10-0.15 (0.13) 0.07-0.12 (0.10)
Mucron 20-25 (21) μm - -
Indicesc
 α 37.59-58.0 (49.96) 34.20-50.0 (41.36) 43.7-66.3 (50.6)
 β1 7.20-10.04 (9.75) 6.63-8.24 (7.18) 7.02-9.92 (8.73)
 β2 10.08-13.94 (12.96) 8.95-10.56 (9.49) 10.01-14.70 (12.5)
 β3 24.34-40.34 (38.68) 23.58-37.50 (29.13) 25.5-39.4 (29.2)
 γ 157.9-290.0 (239.8) 145.57-186.5 (159.08) 167.6-271.3 (213.4)
Duration of report No. of cases (%) reported No. of papers (%) published
1971 1 (0.2) 1 (1.6)
1980-1989 77 (11.9) 18 (28.1)
1990-1999 249 (38.6) 25 (39.1)
2000-2009 163 (25.3) 10 (15.6)
2010 and later 155 (24.0) 10 (15.6)
Total 645 (100) 64 (100)
Locality No. of cases (%)
Jeju-do 217 (34.4)
Gyeongsangnam-do (Jinju-si) 144 (22.8)
Seoul 126 (20.0)
Busan 64 (10.1)
Incheon 41 (6.5)
Gyeongsangbuk-do (Pohang-si) 20 (3.2)
Daegu 5 (0.8)
Gwangju 4 (0.6)
Daejeon 2 (0.3)
Jeollabuk-do 2 (0.3)
Gangwon-do 2 (0.3)
Othersa 4 (0.6)
Total 631 (100)
Age (years) No. of cases (%)
Male Female Total
Below 19 1 6 7 (1.7)
20-29 19 20 39 (9.7)
30-39 62 71 133 (32.9)
40-49 68 72 140 (34.7)
50-59 22 38 60 (14.9)
Over 60 13 12 25 (6.2)
Total 185 (45.8) 219 (54.2) 404 (100)
Fishes (scientific name) No. of cases (%)
Common conger (Conger myriaster) 120 (38.6)
Croaker (Pseudosciaena spp.) 36 (11.6)
Squid 32 (10.3)
Yellowtail (Seriola spp.) 30 (9.7)
Flatfish 17 (5.5)
Pacific cod (Gadus macrocephalus) 6 (1.9)
Anchovy (Engraulis japonica) 4 (1.3)
Rockfish (Sebastes spp.) 4 (1.3)
Sea breams 3 (1.0)
Pacific cutlass fish (Trichiurus lepturus) 3 (1.0)
Gizzard shad (Konosirus punctatus) 2 (0.6)
Skates 2 (0.6)
Othersa 5 (1.6)
Several species of fish mixed 47 (15.1)
Total 311 (100)
Type of larvae No. (%) of larvae identified
Anisakis type I 165 (81.3)a
Anisakis type II 8 (3.9)
Terranova type A 24 (11.8)
Anisakis sp. 3 (1.5)
Contracaecum sp. 3 (1.5)
Total 203 (100)
Location No. (%) of cases
Stomach 333 (82.4)
Small intestinea 46 (11.4)
Gastro-esophageal junction 14 (3.5)
Large intestineb 6 (1.5)
Esophagus 2 (0.5)
Othersc 3 (0.7)
Total 404 (100)
Time (hr) No. (%) of cases
≤6 109 (32.4)
7-12 112 (33.3)
13-24 51 (15.2)
25-72 36 (10.7)
≥ 73 (chronic) 28 (8.3)
Total 336 (100)
Season No. (%) of cases
Spring 71 (23.1)
Summer 56 (18.2)
Autumn 61 (19.9)
Winter 119 (38.8)
Total 307 (100)
Table 1. Summary of the 15 cases of gastric anisakiasis caused by Anisakis type I larvae

Greater curvature.

Nine larvae were detected in each case.

Table 2. Measurementsa and indices of Anisakis type I larvae from human cases

Unit is mm.

from the yellow corvine, Pseudosciaena polyactis.

Legend: α=Body length/Body width; β1=Body length/Esophagus; β2=Body length/Muscular part of esophagus; β3=Body length/Ventriculus; γ=Body length/Tail.

Table 3. Number of anisakiasis cases and number of papers reported among the Korean literature
Table 4. Anisakiasis cases by the occurrence localities

Gyeonggi-do (Uijeongbu-si); Chungcheongbuk-do (Chungju-si), Chungcheongnam-do (Cheonan-si) and Jeollanam-do (Suncheon-si) each 1 case.

Table 5. Age and sex distribution of patients
Table 6. Fishes or cephalopods, the probable source of infection, consumed by anisakiasis cases

Halichoeres tenuispinis (motleystripe rainbowfish), Miichthys miiuy (brown croaker), mullet, tuna and Octopus vulgaris (common octopus) each 1 case.

Table 7. Morphologic identification of anisakid larvae among the literature

15 cases of A. pegreffii were included.

Table 8. Location of worms detected

Ileum (12 cases); jejunum and duodenum (2 cases each).

Colon (5 cases); cecum (1 case).

Palatine tonsil, ileo-cecal region and mesocolic lymph node (1 case each).

Table 9. The time intervals from eating raw flesh of fish to onset of symptoms
Table 10. The frequency of patients by season

Table 1.

Table 2.

Table 3.

Table 4.

Table 5.

Table 6.

Table 7.

Table 8.

Table 9.

Table 10.

PHD : Parasites, Hosts and Diseases

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