Woman Hospitalized With 140 Parasites After Eating Grilled Fish

A 43-year-old woman developed acute abdominal pain just 24 hours after eating grilled fish, and endoscopy revealed more than 140 Anisakis simplex larvae embedded in her stomach. The patient experienced abdominal pain, nausea, low blood pressure, and a rash across her entire body following consumption of grilled spotted golden trevally. Doctors performing upper endoscopy found over 140 Anisakis simplex larvae in her stomach. After removal of the parasites via endoscopy, the patient's condition improved rapidly with no recurrence during a six-month follow-up period.

Anisakiasis is a marine food-borne parasitic disease caused by consuming fish, squid, or other seafood containing stage 3 larvae (L3) of Anisakis species that are either undercooked or eaten raw. Humans are accidental hosts, and while the larvae cannot mature into adult parasites in the human body, they can penetrate the stomach or intestinal lining, causing acute symptoms such as abdominal pain, nausea, and vomiting, and potentially severe allergic reactions.

Although such heavy infections as seen in this patient are rare, the worldwide increase in raw seafood consumption has led to recognition of this disease as an emerging infection that medical professionals should consider, particularly in patients with acute abdominal pain following consumption of raw or undercooked seafood. According to Assoc. Prof. Dr. Jetsada Dondaobunphan, a biology instructor at Chulalongkorn University and science communicator, Anisakis is a roundworm parasite commonly found in wild-caught ocean fish. Consuming it does not cause reproduction within the body but can cause abdominal pain; however, if fish is properly cooked, the parasite dies completely and poses no risk.