TABLE 2.

Summary chronological physiopathology of Anisakis simplex infection in humans

Time after ingestion	Infection event(s)	Factors released or immune response	Tissue events
<1 h	Mucous adhesion	Proteolytic enzymes	Hemorrhagic lesions; worm burrowing and tunnel formation
4 h to 6 days	Mucosa and submucosa penetration	Chemotactic factors	Eosinophilic phlegmon; erosive lesions
7-14 days	Granuloma formation	Hypersensitivity response induction	Ulcerous lesions
>14 days	Larval death	Persistent inflammation or granuloma	Loss of parasite or chronic ulceration around remains