MEDizzy - A 29 year old woman returns from a trip to Vietnam. She

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Infections 1

A 29 year old woman returns from a trip to Vietnam. She ignored pre-travel advice and vaccinations. She ate local foods, including several freshwater fish dishes. One month after her return she starts to note migratory nodules over her abdomen, which are itchy. Her eosinophil count is mildly elevated. What is the most likely cause of this clinical picture?

ExplanationThe presentation suggests exposure to a zoonotic parasite. The clinical scenario with itchy migratory nodules emerging after eating local freshwater fish dishes suggests gnathostomiasis. Ascariasis and filariasis, the latter caused by Wuchereria bancrofti, are not caused by zoonotic parasites while both fascioliasis and Clonorchis sinensis infections primarily involve the hepatobiliary system.