From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.).
J Am Anim Hosp Assoc. 2021 Jan 1;57(1):42-46. doi: 10.5326/JAAHA-MS-6989.
Two young dogs domiciled in Honolulu, Hawaii, were presented in November and December 2018 (respectively) for spinal hyperesthesia, hindlimb weakness, and proprioceptive ataxia. Both dogs had neurologic findings referable to spinal cord disease. Both dogs had a combination of lower motor neuron signs (reduced muscle mass, decreased withdrawal reflexes, low tail carriage) and long tract signs (conscious proprioceptive deficits, crossed extensor response, increased myotatic reflexes). Peripheral eosinophilia was present in the second case, but hematology and serum biochemistries were otherwise unremarkable. Plain radiographs and computed tomography scans ± contrast were unremarkable. Cerebrospinal fluid (CSF) from both patients demonstrated eosinophilic pleocytosis, and real-time polymerase chain reaction testing demonstrated Angiostrongylus cantonensis deoxyribonucleic acid in CSF, confirming a diagnosis of neuroangiostrongyliasis. Treatment included glucocorticoid therapy, ± anthelmintic (fenbendazole). Both dogs made a complete recovery. These are the first confirmed cases of autochthonous neuroangiostrongyliasis in canine patients in the United States and the first dogs anywhere to be diagnosed definitively with A cantonensis infection based on real-time polymerase chain reaction testing of CSF. A clinician examining a patient with severe spinal hyperesthesia and a combination of upper and lower motor signs should consider A cantonensis as a differential, especially in endemic areas.
2018 年 11 月和 12 月，两只位于夏威夷火奴鲁鲁的幼犬因脊柱过敏、后肢无力和本体感觉性共济失调而就诊。两只犬均存在与脊髓疾病相关的神经学表现。两只犬均存在运动神经元疾病的混合表现（肌肉量减少、退缩反射减弱、尾巴低垂）和长束征（有意识的本体感觉缺陷、交叉伸肌反应、肌牵张反射亢进）。第二只犬存在外周嗜酸性粒细胞增多，但血液学和血清生物化学检查无其他异常。普通放射学和计算机断层扫描（加或不加对比）无明显异常。两位患者的脑脊液（CSF）均显示嗜酸性粒细胞增多，实时聚合酶链反应检测显示 CSF 中存在广州管圆线虫脱氧核糖核酸，证实了神经血管圆线虫病的诊断。治疗包括糖皮质激素治疗，加或不加驱虫（芬苯达唑）。两只犬均完全康复。这是美国首例犬类本地感染性神经血管圆线虫病的确诊病例，也是首例通过 CSF 实时聚合酶链反应检测确诊为 A cantonensis 感染的犬病例。检查严重脊柱过敏和上下运动神经元混合征的患者时，临床医生应考虑 A cantonensis 作为鉴别诊断，尤其是在流行地区。
