Angiostrongyliasis

Angiostrongylus cantonensis occurs widely in the tropics. Most infections

occur in Southeast Asia, but small epidemics have been reported more
recently from the Caribbean and elsewhere. Angiostrongylus cantonensis is a
zoonotic parasite that affects rats as the primary hosts. Humans are infected
by eating larvae in undercooked intermediate hosts (e.g. snails, slugs, crabs,
or prawns). Angiostrongylus cantonensis is the most important etiological
agent of eosinophilic meningitis. The larvae migrate to the CNS, where they
can be identified in the meninges, blood vessels and perivascular spaces.
Angiostrongyliasis is an acute disease that spontaneously resolves and rarely
entails sequelae or fatality. It most often presents with headaches, nausea,
vomiting and neck stiffness. Fever is uncommon, but other features of
meningitis, encephalitis and radiculitis may occur. Lumbar puncture pressure
is usually raised, with turbid CSF. The pleocytosis usually has eosinophils and
occasionally the larvae are seen. There is no specific treatment and most
illness resolves in 4–6 weeks.