Infectious Disease Compendium

Angiostrongylus

Microbiology

Helminth (not to be confused with Hellmouth, where Sunnydale High is) includes A. cantonensis and A. costaricensis.

Epidemiologic Risks

Humans are accidental hosts.

Angiostrongylus cantonensis (rat lungworm) is transmitted between rats and mollusks (slugs or snails). Other animals can become infected such as freshwater shrimp, land crabs, frogs, and planarians of the genus Platydemus that are transport hosts transmitting infection to humans if eaten raw or undercooked. So avoid slug sushi, although on occasion there are chopped slugs in that lettace melange on your sandwich.

In SE Asia associated with eating under cooked crabs, shellfish and snails. And raw, yes raw, frogs (PubMed).

A. costaricensis cycles between rats and slugs.

There have been cases in both France, Tennessee and Texas. Nice to know these parts of the world have something in common. I remember when my son was 2 he found a slug and et it before I could react.

Syndromes

A. cantonensis: eosinophilic meningitis. A big problem in Vietnam.

A. costaricensis: eosinophilic gastroenteritis.

Treatment

A. cantonensis: mebendazole 100 mg po bid x 5 d or, perhaps best, albendazole 20 mg/kg dexamethasone 3 mg daily for 7 days (PubMed).

A. costaricensis: mebendazole 200-400 mg po tid x 10 d or thiabendazole 75 mg/kg divided tid x 3 d.

Notes

Last update: 05/05/18