Three Human Gnathostomiasis Cases in Thailand with Molecular Identification of Causative Parasite Species

Jurairat Jongthawin Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Pewpan M. Intapan Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Oranuch Sanpool Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Lakkhana Sadaow Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Penchom Janwan Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Tongjit Thanchomnang Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Apichat Sangchan Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Siriraksa Visaetsilpanonta Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Worasak Keawkong Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Wanchai Maleewong Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand; Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand

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Human gnathostomiasis is one of the important food-borne parasitic zoonoses. The disease is caused by a spirurid roundworm of the genus Gnathostoma. Here, we describe three parasitological confirmed cases of human gnathostomiasis, caused by Gnathostoma spinigerum, in a hospital in Thailand during 2004–2012. Clinical characteristics, treatment, and outcome of cases were revealed. Parasites were accidentally recovered from patients and morphologically identified as Gnathostoma species. Confirmed diagnosis and identification of causative parasite species was made by DNA extraction of the recovered worms, followed by a polymerase chain reaction (PCR) of the second internal transcribed spacer region (ITS2) of DNA and the partial cytochrome c oxidase subunit 1 (cox-1) gene. Sequences corresponding to ITS2 and cox-1 were similar to G. spinigerum. To our knowledge, this study represents the first molecular confirmation that recovered G. spinigerum is a causative agent of human infection in Thailand.

Author Notes

* Address correspondence to Wanchai Maleewong, Department of Parasitology, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Amphur Muang, Khon Kaen 40002, Thailand. E-mail: wanch_ma@kku.ac.th

Financial support: This research was funded by grants from the Higher Education Research Promotion and National Research University Project of Thailand, Office of the Higher Education Commission, Thailand, through the Health Cluster (SHep-GMS) and the Faculty of Medicine, Khon Kaen University (grant no. TR57201). Wanchai Maleewong, Pewpan M. Intapan, and Tongjit Thanchomnang were supported by a TRF Senior Research Scholar Grant, Thailand Research Fund (grant no. RTA5580004).

Authors' addresses: Jurairat Jongthawin, Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mail: jurairat_kku@hotmail.com. Pewpan M. Intapan, Oranuch Sanpool, Lakkhana Sadaow, and Wanchai Maleewong, Department of Parasitology and Research and Diagnostic Center for Infectious Disease, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mails: pewpan@kku.ac.th, sanpoolor@yahoo.com, sadaow1986@gmail.com, and wanch_ma@kku.ac.th. Penchom Janwan, Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand, E-mail: pair_wu@yahoo.com. Tongjit Thanchomnang, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand, E-mail: thanchomnang@yahoo.com. Apichat Sangchan, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mail: apichaz@yahoo.com. Siriraksa Visaetsilpanonta, Retina Unit, Department of Ophthalmology, Udon Thani Hospital, Udon Thani, Thailand, E-mail: trichromats@gmail.com. Worasak Keawkong, Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand, E-mail: worasakk@nu.ac.th.

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