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Eosinophilic meningitis due to Angiostrongylus cantonensis  [cached]
Panackel C,Vishad,Cherian G,Vijayakumar K
Indian Journal of Medical Microbiology , 2006,
Abstract: Angiostrongylus cantonensis is a nematode parasite that inhabits the pulmonary arteries and heart of rodents. It is one of the causative agents of fatal eosinophilic meningoencephalitis in man. We present five cases of eosinophilic meningitis presumably due to infection with Angiostrongylus cantonensis . All the five patients gave history of ingestion of monitor lizard within ten days of onset of symptoms.
Angiostrongylus cantonensis (Nematode: Metastrongyloidea) in molluscs from harbour areas in Brazil
Carvalho, Omar dos Santos;Scholte, Ronaldo Guilherme Carvalho;Mendon?a, Cristiane Lafeta Furtado de;Passos, Liana Konovaloff Jannotti;Caldeira, Roberta Lima;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000600006
Abstract: angiostrongylus cantonensis is the most common aetiological agent of human eosinophilic meningoencephalitis. following a report indicating the presence of this parasite in brazil in 2007, the present study was undertaken to investigate the presence of a. cantonensis in the surrounding brazilian port areas. in total, 30 ports were investigated and the following molluscs were identified: achatina fulica, belocaulus sp., bradybaena similaris sp., cyclodontina sp., helix sp., leptinaria sp., melampus sp., melanoides tuberculata, phyllocaulis sp., pomacea sp., pseudoxychona sp., rhinus sp., sarasinula marginata, streptaxis sp., subulina octona, succinea sp., tomigerus sp., wayampia sp. and specimens belonging to limacidae and orthalicinae. digestion and sedimentation processes were performed and the sediments were examined. dna was extracted from the obtained larvae and the internal transcribed spacer region 2 was analysed by polymerase chain reaction-restriction fragment length polymorphism after digestion with the endonuclease clai. of the 30 ports investigated in this study, 11 contained molluscs infected with a. cantonensis larvae. the set of infected species consisted of s. octona, s. marginata, a. fulica and b. similaris. a total of 36.6% of the investigated ports were positive for a. cantonensis, indicating a wide distribution of this worm. it remains uncertain when and how a. cantonensis was introduced into south america.
A Case Report on Eosinophilic Meningitis Caused by Angiostrongylus cantonensis  [cached]
Jingyao Liu, Jiguo Gao, Chunkui Zhou
International Journal of Medical Sciences , 2011,
Abstract: Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis in humans. It is usually caused by ingestion of raw or inadequately cooked intermediate hosts or food contaminated with infective third-stage larvae. We describe a case of eosinophilic meningitis caused by A. cantonensis in a male Chinese patient. The patient had a history of eating raw fish and snail. We describe the clinical features of the patient, the diagnostic process and treatments. We also provide a brief update for physicians on the characteristics, diagnosis and treatment of eosinophilic meningitis caused by A. cantonensis, with particular emphasis on the update of prevalence and treatment of the disease in China.
Eosinophilic meningitis caused by infection of Angiostrongylus cantonensis in a traveler  [cached]
GUAN Hongzhi,HOI Chupeng,CUI Liying,CHEN Lin
Chinese Journal of Contemporary Neurology and Neurosurgery , 2013, DOI: 10.3969/j.issn.1672-6731.2013.01.012
Abstract: A 55-year-old female traveler returning from South China with acute onset of meningitis, presenting with eosinophilic pleocytosis in the cerebrospinal fluid was reported. The etiological diagnosis of angiostrongyliasis was confirmed by detection of specific serum antibody against Angiostrongylus cantonensis. Angiostrongyliasis should be considered as a major differential diagnosis for eosinophilic meningitis in the travelers to endemic regions.
Intrathecal synthesis of IgE in children with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis
Barbara Padilla-Docal, Alberto J Dorta-Contreras, Raisa Bu-Coifiu-Fanego, Hermes Hernández, Jesús Barroso, Consuelo Sanchez-Martinez
Fluids and Barriers of the CNS , 2008, DOI: 10.1186/1743-8454-5-18
Abstract: Thirteen patients, mean age 4.5 years were studied; a diagnostic lumbar puncture was performed and serum samples taken. Immunoglobulin E (IgE) in serum and in cerebrospinal fluid (CSF) was quantified by nephelometry. Control patients had other infections or other neurological diseases.The mean cell count in the CSF was 500 × 10-6 cells/L and of these 23% were eosinophils. In blood the eosinophils were 13%. The chief symptoms of the patients were migraine, vomiting and fever and 50% presented some meningeal signs. IgE intrathecal synthesis analyzed by the corresponding quotient diagram (Reibergram) was observed in all patients. No intrathecal IgE synthesis was seen in control patients.Intrathecal synthesis of IgE demonstrates the participation of this immunoglobulin in the destruction of the third stage larvae of the parasite in the CSF. The test should be considered in our environment as a tool to aid diagnosis.Eosinophilic meningoencephalitis is a disease caused by the helminth Angiostrongylus cantonensis. The definitive hosts of this parasite are rats, Rattus rattus and Rattus norvegicus [1-3]. Many species of mollusc constitute intermediary hosts [4] and are responsible for the transmission of this zoonosis. Eosinophilic meningoencephalitis described for the first time in Southeast Asia and later in Asia, Africa and the Caribbean [5-8], is considered an important and sometimes fatal human disease. In Cuba this disease is primarily observed in children with a mild course, because the number of larvae accidentally ingested is small. Since 1981, when in the Paediatric Hospital of San Miguel del Padron, the first case was observed in the Americas, an average of 3 cases per year have been reported.IgE plays an important role in anaphylactic type 1-hypersensitivity mechanisms, with high values in patients with parasitic infectious diseases accompanied by eosinophilia [5].In an earlier study [9] on four patients diagnosed with eosinophilic meningoencephalitis caused by
First report of Angiostrongylus cantonensis (Nematoda: Metastrongylidae) in Achatina fulica (Mollusca: Gastropoda) from Southeast and South Brazil
Maldonado Júnior, Arnaldo;Sim?es, Raquel O;Oliveira, Ana Paula M;Motta, Esther M;Fernandez, M?nica A;Pereira, Zilene M;Monteiro, Simone S;Torres, Eduardo J Lopes;Thiengo, Silvana Carvalho;
Memórias do Instituto Oswaldo Cruz , 2010, DOI: 10.1590/S0074-02762010000700019
Abstract: the rat lungworm angiostrongylus cantonensis is a worldwide-distributed zoonotic nematode that can cause human eosinophilic meningoencephalitis. here, for the first time, we report the isolation of a. cantonensis from achatina fulica from two brazilian states: rio de janeiro (specifically the municipalities of barra do piraí, situated at the paraiba river valley region and s?o gon?alo, situated at the edge of guanabara bay) and santa catarina (in municipality of joinville). the lungworms were identified by comparing morphological and morphometrical data obtained from adult worms to values obtained from experimental infections of a. cantonensis from pernambuco, brazil, and akita, japan. only a few minor morphological differences that were determined to represent intra-specific variation were observed. this report of a. cantonensis in south and southeast brazil, together with the recent report of the zoonosis and parasite-infected molluscs in northeast brazil, provide evidence of the wide distribution of a. cantonensis in the country. the need for efforts to better understand the role of a. fulica in the transmission of meningoencephalitis in brazil and the surveillance of molluscs and rodents, particularly in ports, is emphasized.
Mannose-binding lectin deficiency with eosinophilic meningoencephalitis due to Angiostrongylus cantonensis in children: a case series
Bárbara Padilla-Docal, Alberto J Dorta-Contreras, Raisa Bu-Coifiu-Fanego, René H Martínez-Alderete, Olga de Paula-Almeida, Hansotto Reiber, Jens Jensenius
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-330
Abstract: Three Caucasian boys (aged five-years-old, 10-years-old and six-years-old) with a diagnosis of eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis were studied. Serum immunoglobulin A (IgA), IgM, IgG, and complements C3c and C4 levels were quantified by using an immunodiffusion technique. Immunoglobulin E in serum was quantified by nephelometry and mannose-binding lectin by time-resolved fluorometry. Mannose-binding lectin deficiency was observed in the three patients. The first patient showed a reduction in the levels of IgA and IgM and an increase in the values of IgE and C4. The second patient showed a reduction in mannose-binding lectin level with increased IgG, C4 and IgE levels, and the third patient showed a decrease in mannose-binding lectin level and increased levels of IgM and complement C3c as well as a low level of C4.To the best of our knowledge, this is the first report of mannose-binding lectin deficiency associated with Angiostrongylus cantonensis meningoencephalitis in children, and it may contribute to the understanding of the participation of this component of the lectin pathway in the development of the disease.Eosinophilic meningitis, a potentially fatal disease caused by Angiostrongylus cantonensis, a parasitic nematode, is considered an emerging infectious disease [1]. Adult A. cantonensis live in the pulmonary arteries of its definitive hosts, that is, rodents, especially rats, which pass infective first-stage larvae (L1) in their feces. The life cycle also involves mollusks harboring larval stages. In humans, larvae fail to mature, and hence humans and their excreta play no role in the transmission and direct dissemination of the parasite. Humans become infected by ingesting third-stage larvae (L3) in raw or undercooked intermediate host mollusks (for example, snails and slugs) or paratenic hosts (for example, freshwater prawns, crabs, frogs and fish) [1]. Lettuce and vegetable juice have also been identified as sources of
First record of molluscs naturally infected with Angiostrongylus cantonensis (Chen, 1935) (Nematoda: Metastrongylidae) in Brazil
Caldeira, Roberta Lima;Mendon?a, Cristiane LGF;Goveia, Christiane Oliveira;Lenzi, Henrique L;Graeff-Teixeira, Carlos;Lima, Walter S;Mota, Ester M;Pecora, Iracy Lea;Medeiros, Aline Maria Zigiotto de;Carvalho, Omar dos Santos;
Memórias do Instituto Oswaldo Cruz , 2007, DOI: 10.1590/S0074-02762007000700018
Abstract: seeking the identification of angiostrongylus cantonensis as a potential etiological agent of three clinical cases of eosinophilic meningitis, mollusc specimens were collected in the state of espírito santo, brazil. the snails were identified as sarasinula marginata (45 specimens), subulina octona (157), achatina fulica (45) and bradybaena similaris (23). larvae obtained were submitted to polymerase chain reaction and restriction fragment length polymorphism diagnosis. their genetic profile were corresponded to a. cantonensis. rattus norvegicus experimentally infected with third-stage larvae, developed menigoencephalitis, and parasites became sexually mature in the lungs. additionally, larvae obtained from a. fulica snails, from s?o vicente, state of s?o paulo, also showed genetic profiles of this nematode. this is the first record of brazilian molluscs infected with this nematode species.
Phylogenetic relationship of the Brazilian isolates of the rat lungworm Angiostrongylus cantonensis (Nematoda: Metastrongylidae) employing mitochondrial COI gene sequence data  [cached]
Monte Tainá CC,Sim?es Raquel O,Oliveira Ana Paula M,Novaes Clodoaldo F
Parasites & Vectors , 2012, DOI: 10.1186/1756-3305-5-248
Abstract: Background The rat lungworm Angiostrongylus cantonensis can cause eosinophilic meningoencephalitis in humans. This nematode’s main definitive hosts are rodents and its intermediate hosts are snails. This parasite was first described in China and currently is dispersed across several Pacific islands, Asia, Australia, Africa, some Caribbean islands and most recently in the Americas. Here, we report the genetic variability among A. cantonensis isolates from different geographical locations in Brazil using mitochondrial cytochrome c oxidase subunit I (COI) gene sequences. Methods The isolates of A. cantonensis were obtained from distinct geographical locations of Brazil. Genomic DNAs were extracted, amplified by polymerase reaction, purified and sequenced. A partial sequence of COI gene was determined to assess their phylogenetic relationship. Results The sequences of A. cantonensis were monophyletic. We identified a distinct clade that included all isolates of A. cantonensis from Brazil and Asia based on eight distinct haplotypes (ac1, ac2, ac3, ac4, ac5, ac6, ac7 and ac8) from a previous study. Interestingly, the Brazilian haplotype ac5 is clustered with isolates from Japan, and the Brazilian haplotype ac8 from Rio de Janeiro, S o Paulo, Pará and Pernambuco states formed a distinct clade. There is a divergent Brazilian haplotype, which we named ac9, closely related to Chinese haplotype ac6 and Japanese haplotype ac7. Conclusion The genetic variation observed among Brazilian isolates supports the hypothesis that the appearance of A. cantonensis in Brazil is likely a result of multiple introductions of parasite-carrying rats, transported on ships due to active commerce with Africa and Asia during the European colonization period. The rapid spread of the intermediate host, Achatina fulica, also seems to have contributed to the dispersion of this parasite and the infection of the definitive host in different Brazilian regions.
Angiostrongylus costaricensis n. sp. (Nematoda: Metastrongyloidea), a new lungworm occurring in man in Costa Rica
Pedro Morera,Rodolfo Céspedesu
Revista de Biología Tropical , 2002,
Abstract: Angiostrongylus costaricensis n. sp. is described from Costa Rica where it produces lesions in the abdominal cavity of man. It can be distinguished from other species of the genus on the basis of its size, the length of the spicules, the position of the vulva and the morphology and position of the bursal rays. The parasite localizes in the small mesenteric arteries, especially in the ileocecal region, where it produces arteritis and thrombosis. Eggs in various stages of embryonation were found scattered in the tissues of the intestinal wall and regional lymph nodes, eliciting a granulomatous inflammatory reaction with in. tense eosinophilic infiltration Los autores hacen la descripción de Angiostrongylus costaricensis n. sp., un nuevo metastrongilideo encontrado en Costa Rica, que produce lesiones en el hombre. Esta nueva especie se puede distinguir de las otras Catorce descritas hasta ahora, en base a su tama o, la longitud de las espículas, la posición de la vulva y la morfología y disposición de los rayos bursales. A. costaricensis es la segunda especie del género de importancia en parasitología humana. La otra especie patógena para el hombre, A. cantonensis, es responsable de una forma de meningoencefalitis eosinofílica. Los parásitos adultos, machos y hembras, se localizan en las arterias del mesenterio y de la pared intestinal, especialmente de la región ileocecal en donde provocan fenómenos inflamatorios y trombóticos que llevan a grados diversos de necrosis. La presencia de huevos en varios estados de embrionación, en el tejido de la pared intestinal y de los ganglios linfáticos regionales, produce una reacción inflamatoria granulomatosa con intensa infiltración eosinofilica. La pared intestinal se presenta engrosada, llegándose a producir cuadros de suboclusión u oclusión que obligan a intervenciones quirúrgicas de emergencia. La presencia 4e huevos en los tejidos humanos sugiere una mejor adaptación de A. costaricensis en el hombre, en comparación con A. cantonensis, que no llega a alcanzar el estado adulto en los tejidos encefálicos humanos. Sin embargo en los casos en que hemos encontrado larvas completamente formadas, ellas siempre están encerradas en la cáscara del huevo, lo que sugiere la imposibilidad de que las mismas lleguen a la luz intestinal y regresen al suelo para completar su ciclo de vida
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