Angiostrongyliasis : Clinical aspects

Angiostrongyliasis (infection with A. cantonensis, the rat lungworm) has an incubation period of 2-35 days. Symptoms are due to migration of the larvae in the brain and the inflammatory reaction which occurs. The disease presents with acute moderate to severe headache (100%). Besides the headache, patients can complain of eyeball pain. Visual problems can occur, due to involvement of one or more cranial nerves (diplopia, acute strabism, gaze palsy) or due to migration of the larva into the eye, which can lead to retinal detachment and blindness. Facial nerve paralysis occurs occasionally. Nuchal rigidity occurs in about 66% of patients and Brudzinski’s sign is present in ±66%. Transient ataxia can occur. Delirium, seizures and cognitive dysfunction have been observed. Hyperesthesia in various dermatomes occurs. Paresthesias of arms and legs, trunk or face can persist for months, although chronic disease is rare. Vomiting and nausea are self-limited and stop after a few days. Oedema (generalized, legs, facial or migratory) occurs in a minority of patients. Fever occurs in less than 50% of patients. The disease tends to be more serious in children. The disease is self-limiting. Most symptoms disappear spontaneously within 4 weeks of onset (range 2-8 weeks). Mortality is less than 1%.

Category: Medicine Notes