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Comparative infectivity and survival of first-stage larvae of Angiostrongylus cantonensis and Angiostrongylus malaysiensis.

Angiostrongylus malaysiensis was isolated from wild rats Rattus norvegicus in a seaport area of Kitakyushu City, Kyushu, Japan in 1990. The infectivity and survival capacities of first-stage larvae of A. malaysiensis and Angiostrongylus cantonensis were compared under various conditions. Infectivity of first-stage larvae of the former in Biomphalaria glabrata was much lower than that of the latter. In an exposure at various pHs, and with various proteases and tissue homogenates of B. glabrata, the survival of first-stage larvae of A. malaysiensis was also lower than that of A. cantonensis. This lower survival was compared to that of A. cantonensis in response to desiccation of rat feces and high water temperature. First-stage larvae of A. malaysiensis thus appear to be influenced by conditions in the host's feces, specifically temperature and desiccation, and also show a greater sensitivity to pH and component proteases in the snail body than A. cantonensis.

Angiostrongylus↗

Angiostrongyliasis: analysis of antigens of Angiostrongylus costaricensis adult worms versus IgG from infected patients with Angiostrongylus cantonensis.

The possibility of cross-reactivity was previously investigated by indirect ELISA with sera from Angiostrongylus cantonensis infections, normal controls and A. costaricensis antigen. 5 microg/ml of crude antigen from both sexes of each species reacted with diluted serum samples (1:800) of each of 20 cases of angiostrongyliasis and normal controls, and further with anti-human IgG conjugate at 1:1,000. The mean absorbance values were evaluated as follows; normal controls showed a value of 0.033 using A. costaricensis antigen lower than (0.085) A. costaricensis antigen. Both mean values of angiostrongyliasis cases were rather close (0.491) using A. costaricensis antigen and the other antigen (0.518). The present study continued with a crude antigen of 13 A. costaricensis females and males. Serum samples were analyzed; 27 sera of angiostrongyliasis, 30 negative controls and 193 cases of other parasitic infections (91 cases of nematodiasis; 45 cases of cestodiasis; 47 cases of trematodiasis and 10 cases of HIV) and 7 cases of other brain infections. This antigen was evaluated for ELISA with a concentration of 5 microg/ml, serum dilution 1:400 and anti-human IgG conjugate at 1:2,000. The test gave sensitivity and specificity at cut-off value 0.261; 92.59% and 73% respectively. The antigen was cross-reactive with 30 cases from 9 out of 10 different kinds of nematodiasis (gnathostomiasis, strongyloidiasis, ascariasis, hookworm infections, trichinosis, toxocariasis, trichuriasis, onchocercosis and Wuchereria bancrofti infections. Five cases from 3 of 6 kinds of cestodiasis (neurocysticercosis, echinococcosis and Hymenolepis nana infections) and 18 cases of 4 out of 5 kinds of trematodiasis (Paragonimus heterotremus infections, opisthorchiasis, schistosomiasis and fascioliasis). One case of other brain infections was observed. The crude antigen of A. costaricensis showed a high percentage sensitivity with serum antibodies of angiostrongyliasis cases. Low specificity of the test was observed by reactions of those serum antibodies with various kinds of antigenic molecules. This study provides baseline data for further immunodiagnosis of human angiostrongyliasis.

Angiostrongylus cantonensis↗

[Histological studies of the African giant snail (Achatina fulica) experimentally infected with Angiostrongylus vasorum or Angiostrongylus cantonensis (author's transl)].

African Giant Snails (Achatina fulica) about 6 weeks old were experimentally infected with each 5,000 to 20,000 first stage larvae of Angiostrongylus vasorum or A. cantonensis by exposure to a larval suspension. The snails were histologically examined after various intervals after infection: 1 hour post infectionem (p.i.) larvae were present in the foot and 2 hours p.i. in addition in the gastrointestinal tract. 12 hours p.i. larvae were seen for the first time in the lung which reached nearly half of the total number of larvae via the hemolymph system. 24 hours p.i. or later 80-90% of the total larval population were detected in the foot and the lung. In the various organs (lung, mantle, hepatopancreas, gastro-intestinal tract, foot) the larvae were found in the loose connective tissue near or within the hemolymph vessels. The cellular defense mechanism of the snail is activated 12 hours p.i. and the parasites are surrounded by large numbers of leucocytes (leucocytic encapsulation). Three days p.i. the nuclei of the cells become spindle shaped and are forming concentric layers in the outer part of the capsule (fibroblastic type of encapsulation). Later on the wall of the encapsulation becomes thinner and a karyolysis can be recognized in the centre, consequently a cavity occurs. Encapsulations in organs poor in muscle cells can histologically not be differentiated from those located in the foot, which consists mainly of muscle cells; a myofibrous type of encapsulation has to be doubted. The effects of the infection on the snail are discussed.

Animals↗

Systematics of species referred to the genus Angiostrongylus.

Based on morphological criteria of the male bursa, angiostrongylid nematodes often placed in the genus Angiostrongylus Kamensky (1905) were found to be heterogeneous, comprising species which are relegated to 5 distinct genera: Angiostrongylus Kamensky, 1905 (syn. Haemostrongylus Railliet and Henry, 1907); Parastrongylus Baylis, 1928 (syn. Pulmonema Chen, 1935, Rattostrongylus Schulz, 1951, Morerastrongylus Chabaud, 1972, Chabaudistrongylus Kontrimavichus and Delyamure, 1979); Angiocaulus Schulz, Orlov and Kutass, 1933; Gallegostrongylus Mas-Coma, 1977 (syn. Thaistrongylus Ohbayashi, Kamiya and Bhaibulaya, 1979 n. syn); and Stefanskostrongylus Drozdz, 1970. These genera all contain species located primarily in specific host groups: Angiostrongylus in carnivores; Parastrongylus in rodents (Muridae), Angiocaulus in mustelids; Rodentocaulus in rodents (Cricetinae), Gallegostrongylus in rodents (Muridae), and Stefanskostrongylus in insectivores. Species in each genus include: Angiostrongylus (A. vasorum, A. raillieti, A. chabaudi); Parastrongylus (P. tateronae, P. cantonensis, P. mackerrasae, P. sandarsae, P. sciuri, P. petrowi n. comb., P. dujardini, P. schmidti, P. costaricensis n. comb., P. malaysiensis n. comb., P. ryjikovi n. comb., P. siamensis n. comb.); Angiocaulus (A. gubernaculatus, A. ten n. comb., A. sp. Caballero, 1951); Rodentocaulus (R. ondatrae) and Gallegostrongylus (G. ibicensis, G. andersoni, G. harinasutai n. comb.). Angiostrongylus pulmonalis is likely similar to Stefanskostrongylus soricis and is transferred to this genus. Angiostrongylus minutus is removed to Stefanskostrongylus.

Angiostrongylus↗

[Angiostrongylus in the infant at Reunion and Mayotte. Apropos of 3 cases of eosinophilic meningitis including 1 fatal radiculomyeloencephalitis with hydrocephalus].

BACKGROUND: Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT 1: A 11 months old boy living in Mayotte island was hospitalized some days after fever and skin rash with seizure status, coma, flaccid quadriplegia, absence of deep tendon reflexes, urinary retention and anal incontinence. Eosinophilia was observed in peripheral blood and in the cerebrospinal fluid. Secondary, he developed a triventricular hydrocephalus treated by a ventriculoperitoneal shunt. After 3 weeks, the child died. Retrospectively, the diagnosis of angiostrongylus infection was established with the help of serology. CASE REPORTS 2 AND 3: Two infants, 10 and 11 months old boys, living in Reunion island, developed fever and vomitings, irritability and, for one of them, a unilateral sixth cranial nerve palsy. There was eosinophilia in the peripheral blood and in the cerebrospinal fluid. All symptoms progressively disappeared with complete recovery. The suspected diagnosis of angiostrongylus infection was confirmed by the serology. CONCLUSION: We report the first case of Angiostrongylus cantonensis infection in the French island of Mayotte (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms. The origin of these occasionally massive infections is the giant African snail Achatina fulica. For a child with meningitis living in Reunion or Mayotte, or coming back from these 2 islands, Angiostrongylus cantonensis infection must be evoked, especially if there is a blood eosinophilia. Since efficiency of antiparasitic treatment is nowadays not proved, information must be given to people living in exposed areas in view to limit incidence of this disease.

Angiostrongylus cantonensis↗

[Ocular angiostrongylus cantonensis in a female Vietnamese patient: case report].

BACKGROUND: Angiostrongylus cantonensis is largely responsible for human cases of eosinophilic meningitis and meningoencephalitis in the South Pacific and South-East Asia regions. Ocular manifestations of angiostrongylus are relatively rare. We report intraocular infestation and successful removal of a worm from the anterior chamber of a patient in Vietnam. PATIENT AND METHODS: A 3-year old patient was referred to the eye hospital in Ho Chi Minh city, Vietnam, in December 2001 with clinical signs of acute iridocyclitis. The child and his family lived near the Mekong river. The medical history reported by the parents said that the girl had eaten raw snails two weeks before. After a week she developed high fever and for 3 days the right eye was red and painful. Her 8-year old brother was proven to have eosinophilic meningitis at the same time. RESULTS: At first examination, biomicroscopically a 10 mm long and actively mobile, white, round worm was detected in the anterior chamber. Marked hyphema was also present. Routine blood examination showed pronounced eosinophilia. Preoperative treatment with systemic steroids and constriction of the pupil with 1 % pilocarpine were initiated. After immobilising the worm by use of a viscoelastic agent in the anterior chamber, it was successfully removed via a clear-corneal incision. The worm was identified as a male Angiostrongylus cantonensis. Postoperative ophthalmoscopic examination showed an inactive organised cyst at the optic disc border. The child was discharged from the hospital after a week with a visual acuity of 0.6. CONCLUSION: Parasitic infestation is a major health problem in tropical countries. This is the first description of ocular infestation of Angiostrongylus cantonensis in children. No antiparasitic drugs are yet available to treat ocular involvement, thus therapeutic success depends upon early and complete surgical removal of the parasite.

Angiostrongylus cantonensis↗

Necrotizing retinitis induced by Angiostrongylus cantonensis.

PURPOSE: To describe a case of bilateral necrotizing retinitis induced by Angiostrongylus cantonensis. DESIGN: Interventional case report. METHODS: A 52-year-old Asian woman developed eosinophilic meningitis after eating several undercooked snails. One week later, sudden onset of vision loss was noted in both eyes. Widespread yellow retinal exudates were accompanied by bullous retinal detachment in both eyes. RESULTS: Angiostrongylus cantonensis infection was confirmed by positive enzyme-linked immunosorbent assay of the serum and cerebrospinal fluid, and a positive Western blot test of the subretinal fluid. After treatment with mebendazole, levamisole, and corticosteroid, these necrotizing patches regressed gradually. However, the final visual acuity was no light perception. CONCLUSIONS: Angiostrongylus cantonensis infection should be considered as one of the causes of necrotizing retinitis.

Angiostrongylus cantonensis↗

Demonstration of carboxyl and thiol protease activities in adult Schistosoma mansoni, Dirofilaria immitis, Angiostrongylus cantonensis and Ascaris suum.

Evidence has been presented showing two kinds of acidic protease activities in adult Schistosoma mansoni, Dirofilaria immitis, Angiostrongylus cantonensis and Ascaris suum. A haemoglobinolytic activity without adding any SH-containing compounds was maximal at pH 3.5, 2.5, 3.0 and 3.5 in S. mansoni, D. immitis, Angiostrongylus cantonensis and Ascaris suum respectively. The inhibitor studies demonstrated that this activity is ascribable to carboxyl protease(s). In the presence of dithiothreitol, activity on Azocoll (azo-dye coupled hide powder) was maximal at pH 4.6, 4.6, 3.5 and 5.6 in S. mansoni, D. immitis, Angiostrongylus cantonensis and Ascaris suum respectively. The effects of inhibitors demonstrated that this activity belongs to the thiol protease class. The intraspecific distribution of the protease activities was studied in some of the nematodes from which the organs could be anatomically separated. The distribution patterns of the haemoglobinolytic and azocollytic activities were quite different in An. cantonensis and much the same in As. suum. Based on the present results, acidic haemoglobinolytic activities reported in adult S. mansoni by other authors are thought to be due to carboxyl and thiol protease(s) respectively.

Angiostrongylus↗

[IgG subclasses intrathecal synthesis patterns in eosinophilic meningoencephalitis due to Angiostrongylus cantonensis].

INTRODUCTION: There is a growing interest to know the characteristics of meningoencephalitis due to Angiostrongylus cantonensis because of it is an emergent disease. OBJECTIVE: To describe the intrathecal synthesis pattern of IgG subclasses in pediatric patients suffering from eosinophilic meningoencephalitis due to Angiostrongylus cantonensis. PATIENTS AND METHODS: Ten pediatric patients with the disease were studied. During the firs diagnostic lumbar puncture an eosinophilic pleocitosis was found. Simultaneously a serum sample was taken. Eight days later, a second lumbar and venous puncture was performed. To every serum and cerebrospinal fluid sample IgA, IgM, IgG, albumin and the four subclasses of IgG were quantified by immunodiffusion and a differential cell count. RESULTS: During the first diagnostic lumbar puncture, all the cases had blood cerebrospinal fluid barrier dysfunction with absence of immunoglobulins intrathecal synthesis with a mean of 450 106cells/L and 48% of eosinophils average. In the second lumbar punction there was a 40% patients with dysfunction of the blood cerebrospinal fluid barrier and with a synthesis pattern IgA+IgM+IgG in the 50% o patients and with IgA+IgG in four patients. The synthesis pattern of IgG subclasses was IgG1+IgG2 in six patients, IgG1+IgG2+IgG3 in one patient, IgG1+IgG2+IgG4 in one more patient and two patients without intrathecal synthesis. CONCLUSION: The intrathecal synthesis pattern of IgG subclasses can contribute to eosinophilic meningoencephalitis diagnosis due to Angiostrongylus cantonensis.

Angiostrongylus cantonensis↗

[Human angiostrongyliasis caused by Angiostrongylus costaricensis].

Angiostrongylus costaricensis was discovered by Morera and Céspedes in 1971, in a man suffering from an abdominal syndrome. Upon surgery, worms were observed in the cranial mesenteric artery. These worms were assigned to the metastrongylid strongyles and to the genus Angiostrongylus, which was already known, in man medicine, by the species A. cantonensis, the causative agent of an eosinophilic meningitis. Morera's parasite was named Angiostrongylus costaricensis from the place where it was described. A costaricensis is a dixenic parasite, the definitive hosts (D.H.) of which are the cotton-rat (Sigmodon hispidus) and some other rodents. Experimentally, carnivora (Nasua spp: procyonidae) and monkeys (Saguinus mystax: hapalidae) are receptive, same as dogs. The intermediary hosts (I.H.) are slugs belonging to the Veronicellidae family (order gymnophila), mainly Vaginulus plebeius. In the D.H., the parasite produces eggs that hatch into first stage larvae (L1), which are expelled with faeces, eaten by slugs and become infective third stage larvae (L3). L3 are then expelled through mucoïd secretions of the slug and pollute soil and vegetables. D.H. and man get infected with consuming polluted vegetables or even the infected slugs themselves. L3 migrate through lymphatic system and arrive inside the mesenteric artery, where they become adults. In man, the worm can reach this adult egg-laying stage, but larvae are trapped inside granulomas in the intestinal wall and cannot evolve. So, man is a dead-lock for A. costaricensis. Angiostrongylosis costaricensis is an illustration of an hemi-zoonosis (the parasite cannot go back from man to animals) of the biological pattern.

Angiostrongylus↗

Angiostrongylus infections in rats and snails in northeast Thailand.

A survey of Angiostrongylus infections in rats and snails was carried out in the provinces of Ubon Ratchathani, Udon Thani. Kalasin, Chaiyaphum and Khon Kaen in northeast Thailand. Only two Rattus norvegicus (3.8%) and one Bandicota indica (1.4%) out of 151 R. rattus, 52 R. norvegicus and 69 B. indica examined were infected with adult lung worms. All worms recovered were A. cantonensis. Prevalence of infection in 423 Pila polita was 0.9% while all of 77 P. ampullacea were negative for larvae. In contrast to this 36.4% of 500 Achatina fulica harbored L3 of Angiostrongylus (with variations of between 29% and 46% in the five provinces). The average infection intensity in A. fulica was 13.6 L3 (1 to 441). Experimental infection of Wistar rats with L3 (isolated from A. fulica resulted in a recovery rate of 48.3% of adult worms of which 91.7% and 8.3% were identified as A. cantonensis and A. malaysiensis, respectively. This is the first proven finding of A. malaysiensis in northeast Thailand.

Angiostrongylus↗