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Parasitology Lec > Angiostrongylus cantonensis > Flashcards

Angiostrongylus cantonensis Flashcards

1
Q

Angiostrongylus cantonensis

Common Name:

A

Rat Lungworm

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2
Q

Angiostrongylus cantonensis

Was described by Chen in 1935 from domestic_____ in_______

A

rats

Canton, China

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3
Q

Angiostrongylus cantonensis

The worm normally lives in the lungs of______ but can cause___________ in man

A

rats

eosinophilic meningoencephalitis

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4
Q

Angiostrongylus cantonensis

Disease: (2)

A

• Angiostrongyliasis
• Eosinophilic meningoencephalitis

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5
Q

Angiostrongylus cantonensis

  • 16 to 19 mm x 0.26 mm in diameter

Morphology

• Male:

  • pale and filiform
  • they have a well-developed__________
A

caudal bursa (kidney-shaped & single-lobed)

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6
Q

Angiostrongylus cantonensis

Morphology

• Female:

  • pale and filiform
  • 21 to 25 mm x 0.30-0.36 mm in diameter
  • has_______ which are round spirally around the intestine (barber’s pole pattern)
  • lays________ eggs/day
A

uterine tubules

15,000

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7
Q

Angiostrongylus cantonensis

Eggs

• Have delicate_____

• Measure 46-48 micra x 68 micra

•_________ when oviposited

A

hyaline shells

Unembryonated

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8
Q

Angiostrongylus cantonensis

Life Cycle

• Infective stage –
• Definitive host –
• Incidental host –
• Intermediate host –

A

3 rd stage larva

rats

humans

snails (Achantina fulica)

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9
Q

Angiostrongylus cantonensis

Diagnosis

• Relatively difficult

• Presumptive diagnosis is made by travel history and exposure

(3)

A

• CSF (10% eosinophilia in proportion to the WBC)

• CT Scan

• ELISA

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10
Q

Definitive Host

A

• Rats

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11
Q

Intermediate Host

A

Snails or slugs

• Achatina fulica (Giant African Snail), Hemiplecta sagittifera, Helicostyla macrostoma, Veginilus plebeius, Veronicella altae

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12
Q

Paratenic Host

A

• Crabs, freshwater shrimps

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13
Q

Accidental host

A

Humans

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14
Q

Epidemiology

• First human infection documented by Nomura and Lin in_____ in 1945

• Documented in at least___ countries

A

Taiwan

30

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15
Q

Biology: Adult

• 16-22mm by 0.25-0.35mm
• Posterior end: welldeveloped caudal bursa: kidney-shaped and single lobed

A

• Male

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16
Q

Biology of Adult

• 19-33mm by 0.28-0.50mm

• Uterine tubules wound spirally around the intestine observed through the____ cuticle

• _______pattern

• Blunt posterior end

• Lay 15,000 eggs per day

A

Female

transparent

Barber’s pole

17
Q

Biology: Ova

• 46-48um by 68-74um

•______ with delicate_____ shells

•_____ when oviposited

A

Elongated ovoidal eggs; hyaline

Unembryonated

18
Q

Biology: Larva

• Found in lungs of rodents

• Distinct small knob near the tip of the tail

A

Rhabditiform Larva

19
Q

Biology: Larva

• Two well-developed chinitous rods below the buccal cavity

• Rods have expanded knob-like tips

A

• Filariform Larva

20
Q
  1. Ingestion of snails, slugs
  2. Ingestion of paratenic hosts: crabs, freshwater shrimps
A

Humans

21
Q

Pathogenesis and Clinical Manifestations

• BRAIN: primary site of infection

A

Eosinophilic meningoencephalitis

22
Q

• Eosinophils on CSF

• Acute, severe, intermittent occipital or bitemporal headache

• Stiffness of neck, paresthesia, vomiting, fever, nausea, blurred vision, diplopia, myalgia, fatigue

• Confusion, incoherence, disorientation, memory lapses, coma

• Intraocular hemorrhage, blindness

A

Eosinophilic meningoencephalitis

23
Q

Pathogenesis and Clinical Manifestations

eosinophilic inflammation of the mesenteric arterioles of the ileocecal region mimicking appendicitis

A

• Eosinophilic Enteritis

24
Q

Pathogenesis and Clinical Manifestations

: due to dead worms

A

Inflammatory Reaction and Local tissue necrosis

25
Q

Diagnosis

• Relatively difficult to diagnose since the primary site of infection is the____

A

brain

26
Q

Presumptive diagnosis

A

• Travel and exposure history
• Clinical symptoms
• Medical history
• Laboratory findings
• Brain imaging
• Serological tests

27
Q

Diagnosis

• Eosinophilia, elevated eosinophils in CSF similar with other CNS parasitism

A

Blood Tests

28
Q

Diagnosis

• Cerebral edema, hydrocephalus, meningeal lesions

A

CT Scan

29
Q

Treatment

No antihelminthic treatment

(2) may be effective

A

Mebendazole and albendazole

30
Q

Treatment

______of the worm (eyes) Prednisone in severe cases of cranial nerve involvement

(2) for headache

A

Surgical removal

Analgesics and lumbar puncture

31
Q

T or F

Resolve spontaneously: adult worm cannot survive for a long time inside human body

A

TRUE

32
Q

Prevention and Control

• Awareness and education on proper eating habits and food preparation

• Discourage eating raw or poorly cooked ____or unwashed____

• Hand washing after gardening

• Use of molluscicides

• Metaldehyde or iron phosphate food bait pellets

• Copper barriers against snails and slugs

A

mollusks; vegetables

33
Q

_____are ingested by definitive host.

A

Third-stage larvae

34
Q

The ______ in rats are found in pulmonary arteries

A

Adult worms

35
Q

Eggs hatch in the lungs, and ______ are passed in rodent feces

A

first-stage larvae

36
Q

First-stage larvae shed from definitive host are ingested by______

A

gastropod intermediate host

37
Q

Larvae reach the_____
stage after two molts in the intermediate host.

A

infective (third)

38
Q

Larvae migrate to brain (occasionally eyes or lungs) in aberrant human host, and do not reach______

A

reproductive maturity

Parasitology Lec (31 decks)

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