Angiostrongyliasis history and symptoms

Infection first presents with severe abdominal pain, nausea, vomiting, and weakness, which gradually lessens and progresses to fever, and then to CNS symptoms and severe headache and stiffness of the neck.

The clinical symptoms of eosinophilic meningitis are as follows:

• fever is often minor or absent but the presence of high fever suggests severe disease.
• headaches- a bitemporal character in the frontal or occipital lobe
• meningismus – neck stiffness
• photophobia – sensitivity to light
• nausea with or without vomiting
• paresthesias – tingling, prickling, or numbing of skin
• hyperesthesia – severe sensitivity to touch
• bladder dysfunction with urinary retention
• vertigo
• blindness^[1]
• paralysis localized to one area
• general paralysis often ascending in nature starting with the feet and progressing upwards to involve the entire body.
• coma
• death

CNS symptoms begin with mild cognitive impairment and slowed reactions, and in a very severe form often progress to unconsciousness.^[2] Patients may present with neuropathic pain early in the infection. Eventually severe infection will lead to ascending weakness, quadriparesis, areflexia, respiratory failure, and muscle atrophy, and will lead to death if not treated. Occasionally patients present with cranial nerve palsies, usually in nerves 7 and 8, and rarely larvae will enter ocular structures.^[3] Even with treatment, damage to the CNS may be permanent and result in a variety of negative outcomes depending on the location of the infection, and the patient may suffer chronic pain as a result of infection.^[2]

Symptoms of eye invasion include visual impairment, pain, keratitis, and retinal edema. Worms usually appear in the anterior chamber and vitreous and can sometimes be removed surgically.

The parasite is rarely seen outside of endemic areas, and in these cases patients generally have a history of travel to an endemic area.