Kazacos Kevin R, Jelicks Linda A, Tanowitz Herbert B
Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.
Handb Clin Neurol. 2013;114:251-62. doi: 10.1016/B978-0-444-53490-3.00020-0.
Baylisascaris procyonis is a roundworm of the raccoon found primarily in North America but also known to occur in other parts of the world including South America, Europe, and Japan. Migration of the larvae of this parasite is recognized as a cause of clinical neural larva migrans (NLM) in humans, primarily children. It is manifested as meningoencephalitis associated with marked eosinophilia of the cerebrospinal fluid and peripheral blood. Diagnosis is made by recovering and identifying larvae in or from the tissues, epidemiological history, serology, and imaging of the central nervous system. Treatment is with albendazole and steroids, although the prognosis is generally poor. This parasite can also cause ocular larva migrans (OLM) which usually presents as diffuse unilateral subacute neuroretinitis (DUSN). The ocular diagnosis can be made by visualizing the larva in the eye and by serology. Intraocular larvae can be destroyed by photocoagulation although albendazole and steroids may also be used. However, once visual disturbance is established the prognosis for improved vision is poor. Related Baylisascaris species occur in skunks, badgers, and certain other carnivores, although most cases of NLM are caused by B. procyonis. Baylisascaris procyonis has also been found in kinkajous in the USA and South America and may also occur in related procyonids (coatis, olingos, etc.).
浣熊贝蛔虫是浣熊体内的一种蛔虫，主要发现于北美洲，但在世界其他地区也有出现，包括南美洲、欧洲和日本。这种寄生虫的幼虫移行被认为是人类临床神经幼虫移行症（NLM）的病因，主要发生在儿童身上。其表现为与脑脊液和外周血明显嗜酸性粒细胞增多相关的脑膜脑炎。诊断通过在组织中或从组织中发现并鉴定幼虫、流行病学史、血清学以及中枢神经系统成像来进行。治疗使用阿苯达唑和类固醇，尽管预后通常较差。这种寄生虫还可引起眼部幼虫移行症（OLM），通常表现为弥漫性单侧亚急性视网膜神经炎（DUSN）。眼部诊断可通过在眼中观察到幼虫以及血清学检查来进行。眼内幼虫可通过光凝破坏，尽管也可使用阿苯达唑和类固醇。然而，一旦出现视力障碍，改善视力的预后就很差。相关的贝蛔虫种类存在于臭鼬、獾和某些其他食肉动物中，尽管大多数NLM病例是由浣熊贝蛔虫引起的。在美国和南美洲的蜜熊体内也发现了浣熊贝蛔虫，并且可能也存在于相关的浣熊科动物（如长鼻浣熊、尖吻浣熊等）中。
