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Central Nervous System Infections
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Eosinophilic meningoencephalitis is caused by CNS infection by nematodes Angiostrongylus cantonensis and Gnathostoma spinigerum. Angiostrongyliasis is associated with eating uncooked snails, fish, shellfish or vegetables. It is treated with albendazole and steroids, although this may be avoided if it seems to be resolving, as treatment can trigger a strong and sometimes fatal immune reaction. Spinocerebral gnathostomiasis is associated with uncooked fish or seafood and presents with painful radiculitis followed by rapidly advancing myelitis and CNS involvement. Treatment is with albendazole and steroids.
Angiostrongylus
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Praphathip Eamsobhana, Hoi-Sen Yong
Eosinophilic meningitis due to A. cantonensis infection has been classified into three types based on the affected organ: Cerebrospinal angiostrongyliasis cantonensis. The common clinical features include headache (with low-grade or no fever), nausea and vomiting, neck stiffness (signs of meningeal irritation), paresthesia, generalized weakness, seizure, neurologic abnormalities, and occasionally visual disturbances and extraocular muscular paralysis [42,79–81]. The main symptom (or complaint) is acute severe headache as a result of increased intracranial pressure [4,43,82]. The symptoms in most patients may persist from 2 weeks to 2 months before recovery from the abnormality of the cerebrospinal fluid (CSF).Ocular angiostrongyliasis cantonensis. Ocular involvement (changes in vision and visual acuity) may be bilateral or unilateral. The living worm has been observed in various parts of the eye [83–87]—anterior chamber, posterior chamber, retina, subretinal space, vitreous, etc. However, the infection may be located at the pontine instead of the eye. In most cases, the meningitis symptoms are minimal.Pulmonary angiostrongyliasis cantonensis. This clinical entity is due to the presence of adult worm and/or larva in the lung tissue. Living worms have been found in the lungs of a Taiwan patient [88,89], patients in Australia [90] as well as those in Jamaica [91]. In a Thailand case, some larvae migrated to the pulmonary artery and died there [92,93].
Epidemiology and management of foodborne nematodiasis in the European Union, systematic review 2000–2016
Published in Pathogens and Global Health, 2018
Marta Serrano-Moliner, María Morales-Suarez-Varela, M. Adela Valero
Information on angiostrongyliasis originated from 5 papers. No cases were reported in the period between 2000 and 2005. All detected cases [12] in the European Union were imported, either from Cuba, the Philippines, Thailand or Samoa. Five (41.6%) cases were diagnosed only by the clinical history meaning a probable diagnostic [13]; the rest were diagnosed by serology (41.67%) [14,15] and Polymerase Chain Reaction (PCR) (16.66%) [16]. Clinical manifestations develop between 2 to 35 days after the ingestion of larvae [14]. Patients may present neurologic symptoms as photophobia or diffuse paraesthesia in the arms and legs [13,16]. Table 2 shows the results for this parasite.
40th Meeting of the Upper Midwest Neuro-Ophthalmology Group
Published in Neuro-Ophthalmology, 2019
Thomas Mizen, MD, Rush University Medical Center, presented a striking case of angiostrongyliasis (rat lung worm) that led to a retinal detachment. He showed a remarkable surgical video that revealed the worm under the retina during the retinal detachment repair. It was immobilized with laser and removed from the eye through a vitrectomy port.