FDA's Bad Bug Book
Larval Eustrongylides sp. are large, bright red roundworms (nemotodes), 25-150 mm long, 2 mm in diameter. They occur in freshwater fish, brackish water fish and in marine fish. The larvae normally mature in wading birds such as herons, egrets, and flamingos. If the larvae are consumed in undercooked or raw fish, they can attach to the wall of the digestive tract. In the five cases for which clinical symptoms have been reported, the penetration into the gut wall was accompanied by severe pain. The nematodes can perforate the gut wall and probably other organs. Removal of the nematodes by surgical resection or fiber optic devices with forceps is possible if the nematodes penetrate accessible areas of the gut. These large worms may be seen without magnification in the flesh of fish and are normally very active after death of the fish.