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Twenty two cases of canine neural angiostronglyosis in eastern Australia (2002-2005) and a review of the literature

DOI: 10.1186/1756-3305-5-70

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Abstract:

Angiostrongylus cantonensis is a metastrongyloid nematode that normally lives in the right ventricle and pulmonary arteries of rats, its definitive (permissive) host [1]. While many species of rats can carry patent infections, the Norwegian rat (Rattus norvegicus) and the black rat (Rattus rattus) are considered the most important definitive hosts. In wild populations of rats, A. cantonensis infections cause little disease, as expected for an efficient parasite [1-3]. Dogs, humans, horses, Australian native mammals (e.g. possums, macropods, macrobats) and birds (e.g. tawny frogmouths), and various zoo animals are non-permissive "accidental" hosts that become infected after ingesting third-stage larvae (L3) in intermediate hosts (molluscs) [1,4] or transport hosts (such as planarians, frogs, fish and crustaceans) [5-7]. Tawny frogmouths and Australian marsupials are highly susceptible to clinical neural angiostrongylosis.In rats, following digestion, L3 migrate from the gut to peripheral nerves, nerve roots, spinal cord and brain [8]. A. cantonensis shows obligate neurotropism, i.e. larvae must migrate through the central nervous system (CNS) before taking up residence in the pulmonary arteries, where they subsequently mate and produce eggs which embolise in the pulmonary capillary bed. Larvae migrate up the trachea, then are coughed up, swallowed and passed in the stool, where they access intermediate mollusc hosts (slugs or snails). Virtually all species of native and introduced terrestrial molluscs in Australia are suitable intermediate hosts [1].Larval neurotropism dominates disease pathogenesis in non-permissive hosts like dogs and people. In human patients, signs of NA include headache, fever, nausea, vomiting, neck stiffness, paraesthesia, face or limb paralysis, photophobia, diplopia, coma, seizures and even death [9-11]. Canine NA usually results from ingestion of slugs, snails or paratenic hosts containing infective L3 [12-15]. After ingestion, larvae leave

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