Clinical studies on angiostrongyliasis cantonensis among children in Taiwan

Angiostrongyliasis cantonensis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characteristics of angiostrongyliasis cantonensis among 82 children in Taiwan were performed. Thirty-eight (46.3%) were male and 44 (53.7%) females, and 87% could be traced to a history of contact with the intermediate host, the giant African snail, Achatina fulica, which plays a major role in transmission. The incubation period (average: 13.2 days) was shorter in children than in adults (average: 16.5 days). In about one-third (30.5%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (91.5%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 19.5% and 11.0% respectively. Ophthalmologic fundoscopy showed that 25.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 82.9% and 84.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 82 cases was 41.5%; 141 worms were collected from one female patient using a pumping method. In the recent 2 years, albendazole and levamisole were used clinically with good result.