Sawanyawisuth Kanlayanee, Sawanyawisuth Kittisak
Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Trans R Soc Trop Med Hyg. 2008 Oct;102(10):990-6. doi: 10.1016/j.trstmh.2008.04.021. Epub 2008 May 27.
Angiostrongyliasis, caused by Angiostrongylus cantonensis, is endemic in northeastern Thailand and southern and eastern Taiwan and is also reported throughout the world. Humans get infected by eating raw freshwater snails or other paratenic hosts. The three main clinical forms of angiostrongyliasis are: eosinophilic meningitis (EoM), eosinophilic encephalitis (EoE) and ocular angiostrongyliasis. EoM, the most common form, causes acute severe headache, and corticosteroid is the cornerstone treatment. EoE is rare but fatal and has no effective treatment. The clinical presentations are coma and cerebrospinal fluid eosinophils without any other causes of the deterioration of consciousness, such as infection or metabolic derangements. Ocular angiostrongyliasis is very rare and causes a permanent visual impairment and a wide range of ocular inflammation, depending on the worm's route. It can occur with or without EoM. An identification of a living worm, usually a single worm in any part of an eye, is an important diagnostic clue. The treatment options are surgical removal or laser therapy. Corticosteroids may be necessary in the case of coexistence of EoM or other ocular inflammations such as retinitis or optic neuritis. The visual outcome is poor and depends on the initial visual acuity.
由广州管圆线虫引起的管圆线虫病在泰国东北部、中国台湾南部和东部呈地方性流行，世界各地也均有病例报道。人类因食用生的淡水螺或其他转续宿主而感染。管圆线虫病的三种主要临床类型为：嗜酸性粒细胞性脑膜炎（EoM）、嗜酸性粒细胞性脑炎（EoE）和眼部管圆线虫病。EoM是最常见的类型，可导致急性重度头痛，皮质类固醇是主要治疗药物。EoE较为罕见但可致命，且没有有效的治疗方法。临床表现为昏迷和脑脊液嗜酸性粒细胞增多，且不存在导致意识恶化的其他原因，如感染或代谢紊乱。眼部管圆线虫病非常罕见，可导致永久性视力损害和广泛的眼部炎症，具体情况取决于虫体的侵入途径。它可在伴有或不伴有EoM的情况下发生。发现活虫，通常是在眼部任何部位发现单条虫体，是重要的诊断线索。治疗方法包括手术摘除或激光治疗。如果同时存在EoM或其他眼部炎症，如视网膜炎或视神经炎，则可能需要使用皮质类固醇。视力预后较差，取决于初始视力。
