Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People’s Democratic Republic and Review of the Literature
Abstract
:1. Introduction
2. Case Presentations
2.1. Case 1
2.2. Case 2
2.3. Case 3
2.4. Case 4
2.5. Case 5
2.6. Cases 6 and 7
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Wang, Q.-P.; Lai, D.-H.; Zhu, X.-Q.; Chen, X.-G.; Lun, Z.-R. Human angiostrongyliasis. Lancet Infect. Dis. 2008, 8, 621–630. [Google Scholar] [CrossRef]
- Wang, Q.-P.; Wu, Z.-D.; Wei, J.; Owen, R.L.; Lun, Z.-R. Human Angiostrongylus cantonensis: An update. Eur. J. Clin. Microbiol. Infect. Dis. 2012, 31, 389–395. [Google Scholar] [CrossRef]
- Jarvi, S.I.; Quarta, S.; Jacquier, S.; Howe, K.; Bicakci, D.; DaSalla, C.; Lovesy, N.; Snook, K.; McHugh, R.; Niebuhr, C.N. High prevalence of Angiostrongylus cantonensis (rat lungworm) on eastern Hawai’i Island: A closer look at life cycle traits and patterns of infection in wild rats (Rattus spp.). PLoS ONE 2017, 12, e0189458. [Google Scholar] [CrossRef] [Green Version]
- Lv, S.; Zhang, Y.; Steinmann, P.; Zhou, X.-N. Emerging Angiostrongyliasis in Mainland China. Emerg. Infect. Dis. 2008, 14, 161–164. [Google Scholar] [CrossRef] [PubMed]
- Chen, M.-X.; Zhang, R.-L.; Ai, L.; Chen, J.-X.; Chen, S.-H.; Huang, D.-N.; Gao, S.-T.; Geng, Y.-J.; Li, X.-H.; Zhu, X.-Q. Seroprevalence of Angiostrongylus cantonensis Infection in Humans in China. J. Parasitol. 2011, 97, 144–145. [Google Scholar] [CrossRef] [PubMed]
- Ming, D.K.Y.; Rattanavong, S.; Bharucha, T.; Sengvilaipaseuth, O.; Dubot-Pérès, A.; Newton, P.N.; Robinson, M.T. Angiostrongylus cantonensis DNA in cerebrospinal fluid of persons with eosinophilic meningitis, Laos. Emerg. Infect. Dis. 2017, 23, 2112–2113. [Google Scholar] [CrossRef] [Green Version]
- Bhaibulaya, M. Comparative studies on the life history of Angiostrongylus mackerrasae Bhaibulaya, 1968 and Angiostrongylus cantonensis (Chen, 1935). Int. J. Parasitol. 1975, 5, 7–20. [Google Scholar] [CrossRef]
- Cowie, R.H. Pathways for Transmission of Angiostrongyliasis and the Risk of Disease Associated with Them. Hawai’i J. Med. Public Health 2013, 72, 70–74. [Google Scholar]
- Sawanyawisuth, K.; Chotmongkol, V.; Tiamkao, S.; Wilson, D.; Senthong, V.; Sawanyawisuth, K.; Limpawattana, P.; Jitpimolmard, S.; Takahashi, K.; Intapan, P.M.; et al. Clinical Factors Predictive of Encephalitis Caused by Angiostrongylus cantonensis. Am. J. Trop. Med. Hyg. 2009, 81, 698–701. [Google Scholar] [CrossRef] [PubMed]
- Yii, C.-Y. Clinical Observations on Eosinophilic Meningitis and Meningoencephalitis caused by Angiostrongylus Cantonensis on Taiwan. Am. J. Trop. Med. Hyg. 1976, 25, 233–249. [Google Scholar] [CrossRef]
- Chotmongkol, V.; Sawanyawisuth, K. Clinical manifestations and outcome of patients with severe eosinophilic meningoencephalitis presumably caused by Angiostrongylus cantonensis. Southeast Asian J. Trop. Med. Public Health 2002, 33, 231–234. [Google Scholar]
- Wang, H.; Lu, L.; She, D.; Wen, Z.; Mo, Z.; Li, J.; Li, H. Eating Centipedes Can Result in Angiostrongylus cantonensis Infection: Two Case Reports and Pathogen Investigation. Am. J. Trop. Med. Hyg. 2018, 99, 743–748. [Google Scholar] [CrossRef] [Green Version]
- McBride, A.; Chau, T.T.H.; Hong, N.T.T.; Mai, N.T.H.; Anh, N.T.; Thanh, T.T.; Van, T.T.H.; Xuan, L.T.; Sieu, T.P.M.; Thai, L.H.; et al. Angiostrongylus cantonensis Is an Important Cause of Eosinophilic Meningitis in Southern Vietnam. Clin. Infect. Dis. 2017, 64, 1784–1787. [Google Scholar] [CrossRef]
- Lai, C.-H.; Chung, H.-C.; Kuo, H.-C.; Yen, C.-M.; Lin, H.-H.; Chin, C. Eosinophilic Meningitis Caused by Angiostrongylus Cantonensis After Ingestion of Raw Frogs. Am. J. Trop. Med. Hyg. 2007, 76, 399–402. [Google Scholar] [CrossRef] [PubMed]
- Nalini, A.; Ramakrishna, A.; Dekumoy, P.; Kumar, R.R.; Pakdee, W.; Saini, J.; Hegde, V.S. Severe form of radiculo-myelo-neuropathy with meningo—Encephalitis secondary to Angiostrongylus cantonensis infection: Unusual corpus callosal lesions and serial magnetic resonance imaging findings. Neurol. India 2013, 61, 414–418. [Google Scholar] [CrossRef]
- Phongluxa, K.; Xayaseng, V.; Vonghachack, Y.; Akkhavong, K.; Van Eeuwijk, P.; Odermatt, P. Helminth infection in southern Laos: High prevalence and low awareness. Parasites Vectors 2013, 6, 328. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kasper, K.; Schweikhard, J.; Lehmann, M.; Ebert, C.L.; Erbe, P.; Wayakone, S.; Nguyen, T.Q.; Le, M.D.; Ziegler, T. The extent of the illegal trade with terrestrial vertebrates in markets and households in Khammouane Province, Lao PDR. Nat. Conserv. 2020, 41, 25–45. [Google Scholar] [CrossRef]
- Pruvot, M.; Khammavong, K.; Milavong, P.; Philavong, C.; Reinharz, D.; Mayxay, M.; Rattanavong, S.; Horwood, P.; Dussart, P.; Douangngeun, B.; et al. Toward a quantification of risks at the nexus of conservation and health: The case of bushmeat markets in Lao PDR. Sci. Total Environ. 2019, 676, 732–745. [Google Scholar] [CrossRef] [PubMed]
- Radomyos, P.; Tungtrongchitr, A.; Praewanich, R.; Khewwatchan, P.; Kantangkul, T.; Junlananto, P.; Ayudhya, S. Occurance of the infective stage of Angiostrongylus cantonensis in the yellow tree monitor (Varanus bengalensis) in five provinces of Thailand. Southeast Asian J. Trop. Med. Public Health 1994, 25, 498–500. [Google Scholar]
- Qvarnstrom, Y.; Xayavong, M.; Chea, N.; Da Silva, A.C.A.; Heng, S.; Park, S.Y.; Calimlim, P.S.; Johnson, S.; Whelen, A.C.; Fox, L.M.; et al. Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis. Am. J. Trop. Med. Hyg. 2016, 94, 176–181. [Google Scholar] [CrossRef] [Green Version]
- Wang, Q.-P.; Chen, X.-G.; Lun, Z.-R. Invasive freshwater snail, China. Emerg. Infect. Dis. 2007, 13, 1119–1120. [Google Scholar] [CrossRef]
- Kanpittaya, J.; Jitpimolmard, S.; Tiamkao, S.; Mairiang, E. MR findings of eosinophilic meningoencephalitis attributed to Angiostrongylus cantonensis. Am. J. Neuroradiol. 2000, 21, 1090–1094. [Google Scholar]
- Panackel, C.; Cherian, G.; Vijayakumar, K.; Sharma, R.N. Eosinophilic meningitis due to Angiostrongylus cantonensis. Indian J. Med. Microbiol. 2006, 24, 220–221. [Google Scholar] [CrossRef]
- Hidelaratchi, M.D.P.; Riffsy, M.T.M.; Wijesekera, J.C. A case of eosinophilic meningitis following monitor lizard meat consumption, exacerbated by anthelminthics. Ceylon Med. J. 2010, 50, 84–86. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hamide, A.; Johny, J.; Kumar, A.; Kolar, V. Eosinophilic meningitis caused by consumption of meat of monitor lizard (Varanus bengalensis). Neurol. India 2018, 66, 1166. [Google Scholar] [CrossRef]
- Parameswaran, K. Case series of eosinophilic meningoencephalitis from South India. Ann. Indian Acad. Neurol. 2006, 9, 217. [Google Scholar] [CrossRef]
- Pai, S.; Madi, D.; Achappa, B.; Mahalingam, S.; Kendambadi, R. An Interesting Case of Eosinophilic Meningitis. J. Clin. Diagn. Res. 2013, 7, 734–735. [Google Scholar] [CrossRef] [PubMed]
- Rai, S.; Madi, D.; Pai, S.; Baliga, S. Unusual Larva in the CSF and Unique MRI Findings in a Case of Eosinophilic Meningitis. J. Clin. Imaging Sci. 2014, 4, 76. [Google Scholar] [CrossRef]
- Eamsobhana, P. Angiostrongyliasis in Thailand: Epidemiology and Laboratory Investigations. J. Asia Pac. Med. Public Health 2013, 72, 28–32. [Google Scholar]
- Radomyos, P.; Tungtrongchitr, A.; Praewanich, R. Experimental infection of yellow tree monitor (Varanus bengalensis) and related species with Angiostrongylus cantonensis. Southeast Asian J. Trop. Med. Public Health 1992, 23, 167–168. [Google Scholar] [PubMed]
- Feng, Y.; Nawa, Y.; Sawanyavisuth, K.; Lv, Z.; Wu, Z.-D. Comprehensive Review of Ocular Angiostrongyliasis with Special Reference to Optic Neuritis. Korean J. Parasitol. 2013, 51, 613–619. [Google Scholar] [CrossRef] [PubMed]
- Chotmongkol, V.; Sawanyawisuth, K.; Thavornpitak, Y. Corticosteroid Treatment of Eosinophilic Meningitis. Clin. Infect. Dis. 2000, 31, 660–662. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Prociv, P.; Turner, M. Neuroangiostrongyliasis: The “Subarachnoid Phase” and Its Implications for Anthelminthic Therapy. Am. J. Trop. Med. Hyg. 2018, 98, 353–359. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Case Number | 1 | 2 | 3 | 4 | 5 |
---|---|---|---|---|---|
Patient description | |||||
Age, sex | 22, M | 25, M | 24, M | 25, M | 31, M |
Days (hours) after lizard consumption until onset of symptoms | 0 (1–2 h) | 4 | 7 | 7 | 0 (1–2 h) |
Duration of illness (days) | 36 | 32 | 32 | 36 | 39 |
Symptoms | |||||
Headache | Y | Y | Y | Y | Y |
Fever (°C) | Y (39 °C) | N | N | N | N |
Abdominal pain | Y | Y | N | N | Y |
Arthralgia | Y | Y | Y | N | Y |
Myalgia/body pain | Y | Y | Y | Y | Y |
Nausea/vomiting | Y | N | N | Y | Y |
Diarrhea | Y | N | N | N | N |
Loss of appetite | N | Y | Y | N | N |
Neurological | N | Y | Y | Y | Y |
Description of neurological symptoms | n/a | Fatigue, dizziness, papilledema | Fatigue, paraesthesiae | Diplopia, paraesthesiae, muscle weakness | Confusion, stupor, paraesthesiae |
Blood | |||||
WCC (cells/µL) | 11,900 | 8420 | 6700 | 7500 | 8640 |
Neutrophils (%) | 75.9 | 80.8 | 75.9 | 61.0 | 76.0 |
Lymphocytes (%) | 20.5 | 17.2 | 18.2 | 27.0 | 19.0 |
Eosinophils (%) | 32.0 | 0.5 | 0.4 | 4.0 | 0.0 |
Glucose (mg/dL) | 76.1 | 99.1 | 79.2 | 101.0 | 258.0 |
CSF | |||||
Lumbar puncture | Y | N | Y | N | N |
Opening pressure (mm H2O) | 25 | 15 | |||
Lactate (CC) | 20 | 20 | |||
WCC (cells/µL) | 515 | 90 | |||
Neutrophils (%) | 0.0 | 23.0 | |||
Lymphocytes (%) | 44.0 | 11.0 | |||
Eosinophils (%) | 56.0 | 66.0 | |||
Protein (mg/dL) | Albu: 108 | Albu: 126 | |||
Glucose (mg/dL) | 57 | 39 | |||
Days to recovery from treatment start | 9 | 3 | 6 | 7 | 7 |
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Yang, L.; Darasavath, C.; Chang, K.; Vilay, V.; Sengduangphachanh, A.; Adsamouth, A.; Vongsouvath, M.; Keolouangkhot, V.; Robinson, M.T. Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People’s Democratic Republic and Review of the Literature. Trop. Med. Infect. Dis. 2021, 6, 107. https://doi.org/10.3390/tropicalmed6030107
Yang L, Darasavath C, Chang K, Vilay V, Sengduangphachanh A, Adsamouth A, Vongsouvath M, Keolouangkhot V, Robinson MT. Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People’s Democratic Republic and Review of the Literature. Tropical Medicine and Infectious Disease. 2021; 6(3):107. https://doi.org/10.3390/tropicalmed6030107
Chicago/Turabian StyleYang, Leeyounjera, Chirapha Darasavath, Ko Chang, Vilayvanh Vilay, Amphonesavanh Sengduangphachanh, Aphaphone Adsamouth, Manivanh Vongsouvath, Valy Keolouangkhot, and Matthew T. Robinson. 2021. "Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People’s Democratic Republic and Review of the Literature" Tropical Medicine and Infectious Disease 6, no. 3: 107. https://doi.org/10.3390/tropicalmed6030107