Gnathostomiasis (GNT) is a foodborne parasitic infection endemic to Southeast and EastAsia.Its clinical relevance in transplant populations remains poorly defined.We assessed the clinical presentation, management, and outcomes of GNT in kidney transplant candidates and recipients in Thailand (2017Thailand ( -2023)).Eighteen patients were identified (median age 51.5 years; 72.2% male), with 61.1% diagnosed at a median of 8.4 months post-transplant.Diagnosis was based on compatible clinical features and a positive Gnathostoma immunoblot test.Eosinophilia was more common in kidney transplant candidates than recipients (85.7% vs. 27.3%,p = 0.050).Post-transplant recipients predominantly presented with relative eosinophilia (72.7%), skin manifestations (36.4%), and leukopenia (36.4%).Strongyloidiasis co-infection occurred in three patients (16.7%), two of whom had gastrointestinal symptoms.All patients responded to antiparasitic therapy; however, 27.8% of patients required at least one retreatment course for persistent eosinophilic abnormalities.At one year after diagnosis of GNT, the median serum creatinine was 1.4 mg/dL (range, 0.7-11.8).Pre-transplant cases had favorable post-transplant outcomes, with preserved graft function for one year.No deaths occurred.GNT is underrecognized in transplant recipients and often presents atypically, underscoring the need for clinical vigilance, evaluation for co-infection, and longitudinal post-treatment monitoring in endemic regions.
Watcharananan et al. (Wed,) studied this question.