Paediatric angiostrongyliasis

Abstract

<h3>Background</h3> Angiostrongylus cantonensis, a rat lung worm, was first discovered in 1935 in domestic rats in China. The first report of human infection occurred in 1945 in Taiwan. It is endemic in South Asia, the Pacific Islands, Australia and the Carribean. The first human infections in Australia occurred in 1959 in Queensland and increasing numbers of infections in a variety of mammal species have been described on the east coast, as far south as Sydney. It is thought that most, if not all, native and exotic terrestrial molluscs can act as intermediate hosts for <i>Angiostrongylus cantonensis</i>. <h3>Method</h3> Cases presented and literature review. <h3>Results</h3> Two infants with eosinophilic meningitis presented concurrently to the two paediatric referral hospitals in Sydney in April 2011. The first child ultimately succumbed to the illness, despite anti-inflammatory and anti-helminthic treatment, and was diagnosed post-mortem. The second child was managed presumptively with albendazole and corticosteroids, and subsequently serocon-verted. This child required prolonged treatment and has had a slow recovery. <h3>Conclusions</h3> The cases illustrate the variable features of human angiostrongyliasis, and its potential severity. We discuss the clinical, diagnostic and management aspects of angiostrongyliasis. We describe the public health response and discuss possible preventative strategies.