Dear Editor,we read with great interest the article recently published by Morishima L et al. (1 ). The Authors report an high incidence of Anisakis-specific IgE antiboides in patients with anaphylaxis in two towns in Japan.Worlwide the incidence of Anisakis patients is related to the ingestion of raw fish in seaside places. Herein we present the case of a child who has experienced an anaphylaxis with acute respiratory symptoms and a strange scrotal mass, in Calabria, a region completely surrounded by the sea in Southern Italy.An 8-year-old child italian child referred to our Emergency Department with a clinical complaint characterized by acute respiratory distress and right testicular pain since almost 24 hours, that worsened during the day. The respiratory picture resolved almost immediately with the use of corticosteroids via i.v. The clinical examination showed the presence of a painful testicle-independent swelling of about 1 cm in diameter, between the perineal plane and the scrotum, in the absence of signs of inflammation.The doppler ultrasonography demonstrated the presence of phlogistic area at the level of the right epididymis. We decide for home observation and medical therapy (betamethasone and amoxy-clavulanic acid) with mild improvement in symptoms in the following 3 days.After 4 days the child came back to our attention with an important scrotal lymphadenitis consensual to the previous epididymitis, with erythematous and warm scrotal skin. The intense scrotal pain, as in a clinical picture of acute scrotum, did not allow to visit the boy correctly.A second US showed an independent mass from the testicle of about 1 cm.The laboratory findings were completely negative, including testicular markers for tumour.The formula was; white blood cells 5.800, Neutrophiles 48.9%, Lymphocytes 41.8%, Eosinophils 0.8%. At surgical exploration the testicle was normal and a paratesticular granulomatous mass of about 2 cm in diameter was removed.The section of the anatomical specimen in the operatory room left us speechless.Inside the operating specimen we found … Worms! The histological examination confirmed a case of extra-gastrointestinal anisakiasis.