Anisakiasis - A neglected diagnosis in the West

In summary, anisakiasis clinically may simulate peptic ulceration, appendicitis, Crohn's disease and eosinophilic gastroenteritis, or induce allergic manifestations such as urticaria or anaphylaxis. The diagnosis needs to be considered especially in patients presenting with abdominal pain who had consumed raw or undercooked fish in the past 72 h. Eosinophilia may be present. Diagnosis is by endoscopic or microscopic identification of the parasite, the use of X-ray, ultrasound and immunoserology, along with a clinical history of ingestion of raw or undercooked fish. Prevention is by adequate food preparation and storage techniques, and treatment is conservative unless surgery is required for complications, with removal of worms endoscopically or surgically hastening recovery. It is important to be aware of anisakiasis as a problem in Europe and the worm has been demonstrated in a wide range of species of fish in European waters [18].