Albendazole for the Treatment of Anisakiasis Ileus

Patient Sex, age Symptoms No. of days from ingestion of fish to onset of symptoms No. of h from onset of symptoms to the start of therapy Albendazole therapy, no. of days (total no. of tablets) a No. of h from the start of therapy to clinical and radiological resolution Results of the skin prick test for A. simplex Leukocyte count, cells/mL (% eosinophils) Level of specific IgE against a Albendazole was administered at a dosage of 400 mg orally twice per day. References 1. Marchant CD. Gatifloxacin therapy for children: an antibiotic still in the " back room. " Clin Infect Dis 2005; 41:479–80. 2. Pichichero ME, Arguedas A, Dagan R, et al. Safety and efficacy of gatifloxacin therapy for children with recurrent acute otitis media (AOM) and/or AOM treatment failure. Albendazole for the Treatment of Anisakiasis Ileus Sir—Anisakis simplex is a nematode parasite that belongs to the family Anisakidae. Humans can become accidental hosts by eating raw or undercooked fish that contain the third-stage larvae of A. simplex parasites [1]. Clinical presentations of an-isakiasis range from allergic manifestations to different digestive symptoms, depending on the effect the parasite has on the digestive tract wall [1]. Common sites for this disease are the stomach and the small bowel [1]. Clinical diagnosis of intestinal anisakiasis is difficult because the symptoms are not specific. Intestinal anisakiasis may resolve spontaneously with conservative treatment , but some paitents develop serious complications, such as intestinal perforation , or end up requiring surgery because of intestinal obstruction [2, 3]. Here we describe 3 patients with small bowel obstruction who underwent empirical treatment with albendazole on the basis of clinical suspicion of anisakiasis. Informed consent was obtained from all patients, and the ethics committee of our institution approved our study. All 3 patients had a previous history of ingestion of anchovies in vinegar and were admitted to the emergency department with abdominal pain. All had a normal temperature, and x-ray films of the abdomen showed small bowel obstruction, with a dilated small bowel loop and/or air-fluid levels (table 1). Albendazole tablets were administered at a dosage of 400 mg orally twice per day, followed by gastric decompression with a nasogastric tube for 1 h. After this, each patient had A. simplex infection confirmed with a skin-prick test (International Pharmaceutical Immunol-ogy) and/or by the presence of specific IgE against A. simplex (CAP system, Phar-macia). The detection limit …