Vaughan Aisling M, Kamel Dina, Chang Michelle, Saucier Laura, Montgomery Susan P, Wendt Elizabeth, Chang Alicia H, Islam Shamim, Nagiel Aaron, Situ Betty, Middleton Jamie, Terashita Dawn, Balter Sharon, Gibson Joy E, Alarcón Jemma
MMWR Morb Mortal Wkly Rep. 2025 Jul 31;74(28):444-449. doi: 10.15585/mmwr.mm7428a1.
Baylisascaris procyonis (raccoon roundworm), a parasite commonly found in raccoons (Procyon lotor), can cause severe disease in humans when it invades visceral organs or the ocular and central nervous systems. Without prompt treatment, B. procyonis infection can lead to serious complications and death. During September 2024, the Los Angeles County Department of Public Health was notified of two unrelated pediatric patients with neurologic signs and symptoms consistent with baylisascariasis, including behavioral change, lethargy, and gait instability. The first case occurred in an adolescent aged 14 years who had received a previous diagnosis of autism spectrum disorder and had a history of pica (i.e., ingestion of nonfood items); the second case occurred in a previously healthy child aged 15 months. Both were treated with albendazole and corticosteroids. The first patient returned to baseline neurologic status, but delays in diagnosis and treatment of the second patient resulted in severe neurologic sequelae. Epidemiologic investigations identified raccoon feces that had fallen from a rooftop latrine (i.e., a communal raccoon defecation site) as the possible source of exposure for the adolescent. No source of exposure was identified for the younger child. B. procyonis infection should be suspected and prompt treatment considered in patients with neurologic symptoms and cerebrospinal fluid or peripheral blood eosinophilia (>1,000 eosinophils/mL of blood), especially young children or persons with developmental disabilities or pica. In addition, the public should be aware of exposure prevention strategies, including preventing raccoon activity around properties, avoiding exposure to raccoon feces, and safely removing raccoon latrines.
浣熊贝蛔虫（浣熊蛔虫）是一种常见于浣熊（北美浣熊）体内的寄生虫，当它侵入人体内脏器官或眼及中枢神经系统时，可导致严重疾病。若不及时治疗，浣熊贝蛔虫感染可引发严重并发症甚至死亡。2024年9月，洛杉矶县公共卫生部接到通报，有两名无关联的儿科患者出现了与浣熊蛔虫病相符的神经体征和症状，包括行为改变、嗜睡和步态不稳。第一例发生在一名14岁的青少年身上，该青少年此前被诊断患有自闭症谱系障碍，并有异食癖病史（即摄入非食物物品）；第二例发生在一名此前健康的15个月大儿童身上。两名患者均接受了阿苯达唑和皮质类固醇治疗。第一名患者的神经状态恢复到了基线水平，但第二名患者诊断和治疗的延迟导致了严重的神经后遗症。流行病学调查确定，从屋顶厕所（即浣熊公共排便场所）掉落的浣熊粪便可能是该青少年的暴露源。未确定年幼儿童的暴露源。对于出现神经症状且脑脊液或外周血嗜酸性粒细胞增多（>1000个嗜酸性粒细胞/毫升血液）的患者，尤其是幼儿或有发育障碍或异食癖的人，应怀疑感染了浣熊贝蛔虫并考虑及时治疗。此外，公众应了解暴露预防策略，包括防止浣熊在房产周围活动、避免接触浣熊粪便以及安全移除浣熊厕所。
