TABLE 2.

Summary chronological physiopathology of Anisakis simplex infection in humans

Time after ingestionInfection event(s)Factors released or immune responseTissue events
<1 hMucous adhesionProteolytic enzymesHemorrhagic lesions; worm burrowing and tunnel formation
4 h to 6 daysMucosa and submucosa penetrationChemotactic factorsEosinophilic phlegmon; erosive lesions
7-14 daysGranuloma formationHypersensitivity response inductionUlcerous lesions
>14 daysLarval deathPersistent inflammation or granulomaLoss of parasite or chronic ulceration around remains