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Parasitology. 2016 Aug;143(9):1087-118. doi: 10.1017/S0031182016000652. Epub 2016 May 26.

Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen.

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i3 Institute, University of Technology Sydney,Ultimo,NSW,Australia.
Department of Microbiology,SydPath, St. Vincent's Hospital,Victoria St.,Darlinghurst,NSW,Australia.
Centre for Veterinary Education, B22,The University of Sydney,NSW 2006,Australia.
Faculty of Veterinary Science,The University of Sydney,Sydney, NSW 2006,Australia.
ICPMR, Westmead Clinical School, Westmead Hospital,Westmead,NSW 2065,Australia.
School of Life Sciences, University of TechnologySydney,Ultimo,NSW,Australia.


Angiostrongylus cantonensis is a metastrongyloid nematode found widely in the Asia-Pacific region, and the aetiological agent of angiostrongyliasis; a disease characterized by eosinophilic meningitis. Rattus rats are definitive hosts of A. cantonensis, while intermediate hosts include terrestrial and aquatic molluscs. Humans are dead-end hosts that usually become infected upon ingestion of infected molluscs. A presumptive diagnosis is often made based on clinical features, a history of mollusc consumption, eosinophilic pleocytosis in cerebral spinal fluid, and advanced imaging such as computed tomography. Serological tests are available for angiostrongyliasis, though many tests are still under development. While there is no treatment consensus, therapy often includes a combination of anthelmintics and corticosteroids. Angiostrongyliasis is relatively rare, but is often associated with morbidity and sometimes mortality. Recent reports suggest the parasites' range is increasing, leading to fatalities in regions previously considered Angiostrongylus-free, and sometimes, delayed diagnosis in newly invaded regions. Increased awareness of angiostrongyliasis would facilitate rapid diagnosis and improved clinical outcomes. This paper summarizes knowledge on the parasites' life cycle, clinical aspects and epidemiology. The molecular biology of Angiostrongylus spp. is also discussed. Attention is paid to the significance of angiostrongyliasis in Australia, given the recent severe cases reported from the Sydney region.


Angiostrongyliasis; Angiostrongylus; Clinical significance; Diagnosis; Eosinophilic meningitis; Epidemiology; Lungworm; Molecular biology; Molluscs; Rat

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