Urinary gnathostomiasis in a Laotian refugee.

Gnathostoma spinigerum is an uncommonly encountered parasite, even in a practice such as ours, which hosts a Traveler's Clinic and provides care for a relatively large Southeast Asian population. Gnathostomiasis is most commonly reported in Asia, particularly Thailand and J apan.1 N onetheless, gnathostomiasis is a potentially serious, even life-threatening, parasitosis that can be seen in any primary care setting that provides health care for Southeast Asian refugee populations. As of 30 September 1990, the Southeast Asian refugee population of the United States was estimated to total 957,100, with refugees in every state and large populations in California (378,500), Texas (71,800), Washington (44,900), Minnesota (34,900), and New York (34,300).2 Consequently, although this parasite is reportedly rare in the United States, family physicians could well encounter Southeast Asian refugee patients and should be familiar with the clinical presentations of this parasite. We present a case of urinary gnathostomiasis in a Laotian refugee. To our knowledge, this case is only the second reported in the United States. The first case of urinary gnathostomiasis in the United States was reported in 1984.3