There are seven genera of spirudia nematodes that infect human hosts accidentally: Gnathostoma, Thelazia, Gongylonema, Physaloptera, Spirocerca, Rictularia.

They have numerous rear mucosal projections, which assumedly assist propulsion through the thin layer of skin on the inside of the human host's mouth.

[citation needed] Transmission to humans is due mostly to unsanitary conditions and the ingestion of infected coprophagous insects, mostly dung beetles and cockroaches.

Also, contaminated water sources, again with the intermediate hosts or the infective third stage larva, can lead to transmission to humans.

It is non-keratinized stratified squamous epithelium, and is continuous with the mucosae of the soft palate, the undersurface of the tongue and the floor of the mouth.

The vector and intermediate host for Gongylonema pulchrum infections are coprophagous insects (dung beetles and cockroaches).

The larvae all possess a cephalic hook and rows of tiny spines around a blunt anterior end, so when they hatch they may further infest their hosts.

[citation needed] The morphology of the worm is as follows, from a 2000 Veterinary Medicine study: "The anterior end in both sexes was covered by numerous cuticular platelets.

[citation needed] In humans, the hypothesized life cycle is as follows: Ingestion of contaminated food, water, or infected dung beetle.

[citation needed] With initial infection, some patients have reported remembering a mild fever and flu-like symptoms about a month previous to extraction or identification of worm.

Subjects commonly pull worms from their gums, tongue, lips, and inner cheeks after days and even weeks of reported discomfort.

In animals, this parasite quickly spreads down the esophagus, and into the upper digestive and respiratory tracts, making it more often than not, fatal.

Diagnosis is often made by visible recognition of the worm moving through the tissue of the buccal cavity by either patient or doctor.

Microscopic identification of worm removed from patient's mouth or tissue is another diagnostic technique for determining the parasite infection.

[citation needed] Treatment for infections with G. pulchrum is surgical/manual extraction of the noticed worm and albendazole (400 milligrams twice daily for 21 days).

Follow up measures include periodic checks of buccal cavity and esophagus to ensure parasite infection has cleared.

Another control measure is ensuring children and adults do not accidentally or purposefully ingest infected dung beetles and other coprophagous insects.

[5] Also in 1999, a 38-year-old woman of Cambridge, Massachusetts sought medical attention for the visible identification of a “migrating mass” in her cheek mucosa.

Approximately 12 hours after eating the food, she and five other individuals she was traveling with had an acute attack of nausea, vomiting, and dizziness.

A small female Gongylonema worm was surgically removed from her cheek mucosa under local anesthesia, and follow up treatment included albendazole two times daily for three days.

He extracted the worm with a sewing needle, and the child's complaints stopped and she appeared to have no further symptoms of parasite infection.

Initially, the patient would occasionally feel, but not see, this mass at different sites: cheek, palate, gums and internal surface of the lower lip.

Haematology investigation revealed no abnormalities, particularly no elevated eosinophil count, and no microfilariae were seen using stained blood films; the filariasis serology was negative.

After 3 weeks of migration, the thread-like worm installed itself on the inner surface of the lower lip, allowing the patient to extract it by tongue pressure firstly, then using his fingers.