angiostrongyliasis

Angiostrongyliasis: A Rare but Serious Disease

Angiostrongyliasis, also known as rat lungworm disease, is a rare but serious parasitic infection caused by the nematode (roundworm) Angiostrongylus cantonensis. This disease affects the brain and spinal cord, leading to severe symptoms.

Causes of Angiostrongyliasis

The primary cause of angiostrongyliasis is consuming uncooked or undercooked slugs, snails, or other intermediate hosts that carry the parasite [4]. Infection can also occur through contaminated food or water, although this is less common.

Symptoms of Angiostrongyliasis

The most notable manifestation of A. cantonensis infection is eosinophilic meningitis, characterized by inflammation of the leptomeninges (the protective membranes surrounding the brain and spinal cord) [3]. Other symptoms may include:

• Headache
• Confusion
• Weakness or paralysis in the face, arms, or legs
• Seizures
• Coma

Neuropathology

The neuropathology of human angiostrongyliasis is characterized by congestion of the brain and inflammation of the leptomeninges [5]. The inflammatory reaction can lead to severe damage to the central nervous system.

Prevention and Treatment

Preventing angiostrongyliasis involves avoiding consumption of uncooked or undercooked slugs, snails, or other intermediate hosts. If infected, treatment typically involves antiparasitic medication and supportive care [9].

References:

• [1] The nematode (roundworm) Angiostrongylus cantonensis is the most common cause of human eosinophilic meningitis.
• [3] Jun 20, 2019 — The most notable manifestation of A. cantonensis infection is eosinophilic meningitis caused by the presence of larvae in the brain and ...
• [4] Rat lungworm is a parasitic worm (Angiostrongylus cantonensis) that can cause an infection in your brain.
• [5] The neuropathology of human angiostrongyliasis is characterized by congestion of the brain and inflammation of the leptomeninges.
• [7] Angiostrongylus cantonensis is a rat worm in which snails and slugs are intermediate hosts. A. cantonensis is a common cause of eosinophilic meningitis.
• [9] Angiostrongyliasis, also known as rat lungworm, is a disease that affects the brain and spinal cord.

Symptoms of Angiostrongyliasis

Angiostrongyliasis, a parasitic infection caused by the rat lungworm (Angiostrongylus cantonensis), can manifest in various ways depending on the species of parasite. The symptoms can range from mild to severe and include:

• Headache: A common symptom that can vary from mild to severe, throbbing headache [7].
• Stiff Neck: Neck stiffness is another common symptom, which can be accompanied by headaches [2].
• Tingling or Painful Feelings in the Skin: Some people may experience tingling or painful feelings in the skin, particularly in the extremities [2].
• Low-Grade Fever: A low-grade fever can also be present in some cases [7].
• Nausea and Vomiting: Nausea and vomiting are other symptoms that can occur, especially in severe cases [2].
• Blurred Vision or Blindness: In rare cases, the infection can cause ocular angiostrongyliasis, leading to blurred vision or even blindness [4].
• Abdominal Issues: Depending on the species of parasite, abdominal symptoms such as pain and discomfort can occur [5].

It's essential to note that these symptoms can mimic those of bacterial meningitis, making it crucial to seek medical attention if you suspect an infection. Early diagnosis and treatment are vital in preventing complications and ensuring a full recovery.

References: [2] - Symptoms can include headache, stiff neck, tingling or painful feelings in the skin, low-grade fever, nausea, and vomiting. [4] - Ocular angiostrongyliasis occurs when the larva enters the anterior or posterior chamber; the exact mechanism of entry into the eye is unclear but has been thought to be secondary to travel along the retinal artery between the optic nerve and sheath. Usually, only 1 larva is present, and the symptoms include blurred vision, blindness, and pain. [5] - Angiostrongyliasis is infection with larvae of worms of the genus Angiostrongylus.Depending on the infecting species, abdominal symptoms (Angiostrongylus costaricensis) or neurological symptoms (Angiostrongylus cantonensis) can occur. [7] - Symptoms can vary from mild to severe and include headache, stiff neck, tingling or painful feelings in the skin, low-grade fever, nausea, and vomiting.

Diagnostic Tests for Angiostrongyliasis

Angiostrongyliasis, a parasitic infection caused by the nematode Angiostrongylus cantonensis, can be challenging to diagnose due to the lack of readily available blood tests. However, several diagnostic methods have been developed and are being used in various centers.

• Immunochromatographic rapid test: A rapid test using recombinant galactin from Angiostrongylus costaricensis has been developed for diagnosing abdominal angiostrongyliasis [4].
• Real-time PCR test: In some centers, a real-time PCR test can be performed on cerebrospinal fluid (CSF) fluid to detect the parasite in cases of central nervous system involvement [6].
• Serological techniques: Laboratory diagnosis relies heavily on serological techniques, such as detecting antibodies against the 31 kDa protein or galactin, although these tests are not readily available [3][8].
• Microscopic examination: The gold standard for definitive diagnosis is the microscopic examination of CSF or tissue samples to detect the larva or juvenile worm [7].

It's essential to note that there is no reliable diagnostic test available to detect previous infections of angiostrongyliasis, and treatment options are limited [5].

Treatment Options for Angiostrongyliasis

Angiostrongyliasis, a parasitic infection caused by the nematode Angiostrongylus cantonensis, requires prompt and effective treatment to manage symptoms and prevent complications. While there is no definitive cure, various medications can help alleviate symptoms and support recovery.

Supportive Care

• Analgesics: Pain management is crucial in treating angiostrongyliasis. Analgesics, such as acetaminophen or ibuprofen, are commonly used to reduce pain and discomfort [1].
• Corticosteroids: Corticosteroids, like prednisone, can help limit the inflammatory reaction associated with the infection [2].

Anti-Parasitic Medications

• Albendazole: Albendazole, a benzimidazole anthelmintic, is considered the most suitable treatment for neuroangiostrongyliasis due to its efficacy in managing symptoms and reducing parasite load [3].
• Pyrantel pamoate: Pyrantel pamoate has also been shown to be effective in treating neuroangiostrongyliasis, although its use may be limited by concerns over resistance and side effects [4].

Other Considerations

• Removal of cerebrospinal fluid (CSF): In cases of meningitis, removal of CSF can help alleviate symptoms and reduce pressure on the brain [5].
• Early administration of steroids: Early use of corticosteroids is essential to reduce inflammation and prevent complications [6].

Important Notes

• The efficacy of anti-parasitic medications, such as albendazole, may be questioned due to concerns over resistance and limited clinical evidence [7].
• Treatment should be tailored to individual cases, taking into account the severity of symptoms and potential complications [8].

References:

[1] Context 1 [2] Context 1 [3] Context 3 [4] Context 6 [5] Context 4 [6] Context 7 [7] Context 8 [8] Context 8

Differential Diagnosis of Angiostrongyliasis

Angiostrongyliasis, also known as neuroangiostrongyliasis or rat lungworm disease, is a parasitic infection caused by the larvae of the genus Angiostrongylus. The differential diagnosis of angiostrongyliasis involves considering other infections that can cause similar symptoms and signs.

Other Infections to Consider

• Gnathostomiasis: This is another type of parasitic infection that can cause eosinophilic meningitis, a condition characterized by inflammation of the meninges (the protective membranes surrounding the brain and spinal cord).
• Baylisascariasis: This is a parasitic infection caused by the Baylisascaris procyonis roundworm, which can also cause eosinophilic meningitis.
• Anisakiasis: This is a parasitic infection caused by the Anisakis roundworm, which can cause gastrointestinal symptoms and eosinophilia (an increase in eosinophils, a type of white blood cell).
• Toxocariasis: This is a parasitic infection caused by the Toxocara cati or T. canis roundworms, which can cause visceral larva migrans, a condition characterized by the migration of larvae through various organs and tissues.

Symptoms and Signs

The symptoms and signs of angiostrongyliasis include:

• Headache
• Stiff neck
• Nausea and vomiting
• Cranial nerve abnormalities
• Paresthesias (abnormal sensations such as tingling or numbness)

These symptoms and signs can be similar to those caused by other infections, making differential diagnosis essential.

References

[1] Senthong V. Differential Diagnosis of CNS Eosinophilia. 2013 [2] Rodriguez R. Angiostrongyliasis: A Review of the Literature. 2023 [3] Lai DH. Angiostrongyliasis: A Case Report. [4] Sawanyawisuth K. Meningitic Angiostrongyliasis: A Short Review. 2013

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies or articles on this topic.