ICD-10: B83.2

Angiostrongyliasis due to Parastrongylus cantonensis, classified under ICD-10 code B83.2, is a parasitic infection primarily affecting the central nervous system. This condition is caused by the nematode Parastrongylus cantonensis, which is commonly associated with eosinophilic meningitis. Below is a detailed overview of the clinical description, symptoms, transmission, diagnosis, and treatment options for this condition.

Clinical Description

Causative Agent

Parastrongylus cantonensis is a parasitic roundworm that typically resides in the pulmonary arteries of rats, which are the primary hosts. Humans can become accidental hosts through the ingestion of larvae present in contaminated food or water, particularly in regions where the parasite is endemic.

Pathophysiology

Once ingested, the larvae migrate through the body, often reaching the central nervous system, where they can cause inflammation and damage to the meninges and brain tissue. This leads to a condition known as eosinophilic meningitis, characterized by an elevated eosinophil count in the cerebrospinal fluid (CSF).

Symptoms

The clinical presentation of angiostrongyliasis can vary, but common symptoms include:

• Headache: Often severe and persistent.
• Fever: Low-grade fever may be present.
• Neck Stiffness: Indicative of meningeal irritation.
• Nausea and Vomiting: Common gastrointestinal symptoms.
• Altered Mental Status: Ranging from confusion to coma in severe cases.
• Visual Disturbances: Such as blurred vision or double vision.

Symptoms typically appear 1-3 weeks after exposure, and the severity can vary based on the individual’s immune response and the extent of the infection.

Transmission

The primary mode of transmission is through the ingestion of larvae found in contaminated food, particularly raw or undercooked snails, slugs, or vegetables that have been exposed to these hosts. The parasite can also be transmitted through contaminated water sources. It is important to note that the infection is not transmitted from person to person.

Diagnosis

Diagnosis of angiostrongyliasis due to Parastrongylus cantonensis involves:

• Clinical Evaluation: Assessment of symptoms and medical history.
• Cerebrospinal Fluid Analysis: A lumbar puncture may reveal elevated eosinophils, which is a hallmark of eosinophilic meningitis.
• Serological Tests: Detection of specific antibodies against the parasite can aid in diagnosis.
• Imaging Studies: MRI or CT scans may be used to assess any neurological complications.

Treatment

There is no specific antiviral or antiparasitic treatment for angiostrongyliasis. Management typically focuses on symptomatic relief and may include:

• Corticosteroids: To reduce inflammation and swelling in the central nervous system.
• Pain Management: Analgesics for headache relief.
• Supportive Care: Hydration and monitoring of neurological status.

In severe cases, hospitalization may be required for close monitoring and management of complications.

Conclusion

Angiostrongyliasis due to Parastrongylus cantonensis is a significant public health concern in endemic areas, particularly in tropical and subtropical regions. Awareness of the transmission routes, clinical symptoms, and diagnostic methods is crucial for timely intervention and management. Preventive measures, such as proper cooking of food and avoiding contaminated water sources, are essential to reduce the risk of infection.

Angiostrongyliasis, specifically due to Parastrongylus cantonensis, is a parasitic infection that primarily affects the central nervous system, leading to a condition known as eosinophilic meningitis. This infection is caused by the larvae of the rat lungworm, which can be transmitted to humans through contaminated food or water, particularly raw or undercooked snails and slugs.

Clinical Presentation

The clinical presentation of angiostrongyliasis can vary significantly among patients, but it typically includes a range of neurological and systemic symptoms. The onset of symptoms may occur several days to weeks after exposure to the parasite.

Common Signs and Symptoms

1. Neurological Symptoms:
   - Headache: Often severe and persistent, it is one of the most common initial symptoms.
   - Meningeal Signs: These may include neck stiffness, photophobia (sensitivity to light), and a positive Brudzinski's sign (involuntary lifting of the legs when the neck is flexed).
   - Altered Mental Status: Patients may experience confusion, lethargy, or even coma in severe cases.

2. Systemic Symptoms:
   - Fever: A low-grade fever is common.
   - Nausea and Vomiting: Gastrointestinal symptoms may accompany the neurological manifestations.
   - Muscle Pain: Myalgia can occur, contributing to the overall discomfort.

3. Eosinophilia: Laboratory findings often reveal an elevated eosinophil count in the blood and cerebrospinal fluid (CSF), which is a hallmark of eosinophilic meningitis.

Patient Characteristics

Patients at risk for Parastrongylus cantonensis infection typically share certain characteristics:

• Geographic Location: The infection is more prevalent in tropical and subtropical regions, particularly in areas where the rat population is high and where snails and slugs are common.
• Dietary Habits: Individuals who consume raw or undercooked snails, slugs, or contaminated vegetables are at increased risk.
• Age and Immune Status: While anyone can be infected, children and immunocompromised individuals may experience more severe symptoms due to their less robust immune responses.

Diagnosis and Management

Diagnosis of angiostrongyliasis is primarily based on clinical presentation, patient history, and laboratory tests. The presence of eosinophilia in the CSF is a significant indicator. Imaging studies, such as MRI or CT scans, may be utilized to assess any neurological complications.

Management of the condition is largely supportive, focusing on alleviating symptoms. Corticosteroids may be prescribed to reduce inflammation in severe cases, but antiparasitic treatment is generally not effective against the larvae once they have invaded the central nervous system.

Conclusion

Angiostrongyliasis due to Parastrongylus cantonensis presents a unique clinical challenge, characterized by a combination of neurological and systemic symptoms. Understanding the signs, symptoms, and patient characteristics associated with this infection is crucial for timely diagnosis and management. Awareness of the risk factors, particularly dietary habits and geographic exposure, can help in preventing this potentially serious condition.

Angiostrongyliasis due to Parastrongylus cantonensis, classified under ICD-10 code B83.2, is a parasitic infection primarily affecting the central nervous system. This condition is often associated with the consumption of contaminated food or water, particularly in regions where the parasite is endemic. Below are alternative names and related terms for this condition.

Alternative Names

1. Eosinophilic Meningitis: This term is often used to describe the inflammatory response in the meninges caused by the infection, characterized by an elevated eosinophil count in the cerebrospinal fluid (CSF) [1].

2. Rat Lungworm Disease: This name derives from the primary host of the parasite, which is often found in rats. Humans can become accidental hosts through ingestion of contaminated snails or slugs [2].

3. Parastrongyliasis: This term refers specifically to infections caused by the Parastrongylus genus, which includes P. cantonensis as a significant species affecting humans [3].

4. Cerebral Angiostrongyliasis: This term emphasizes the neurological aspects of the disease, particularly when the infection leads to severe central nervous system symptoms [4].

Related Terms

1. Helminthiasis: A broader term that encompasses infections caused by helminths (parasitic worms), including those caused by Parastrongylus cantonensis [5].

2. Neuroangiostrongyliasis: This term highlights the neurological implications of the infection, particularly when it leads to conditions such as meningitis or encephalitis [6].

3. Eosinophilic Meningoencephalitis: This term is used when the infection results in both meningitis and encephalitis, characterized by eosinophilic pleocytosis in the CSF [7].

4. Parasitic Meningitis: A general term that can refer to any meningitis caused by parasitic infections, including those caused by P. cantonensis [8].

5. Lungworm Infection: While this term is more general, it can refer to infections caused by various lungworms, including Parastrongylus cantonensis [9].

Conclusion

Understanding the various names and related terms for angiostrongyliasis due to Parastrongylus cantonensis can aid in better communication among healthcare professionals and enhance awareness of the disease. This knowledge is particularly important for diagnosis and treatment, especially in endemic regions where the risk of infection is higher. If you have further questions or need more specific information, feel free to ask!

Angiostrongyliasis, specifically due to Parastrongylus cantonensis, is classified under the ICD-10 code B83.2. This parasitic infection primarily affects the central nervous system and is often associated with eosinophilic meningitis. The diagnosis of this condition involves several criteria, which can be categorized into clinical, laboratory, and epidemiological aspects.

Clinical Criteria

1. Symptoms: Patients typically present with symptoms such as:
   - Headache
   - Fever
   - Nausea and vomiting
   - Stiff neck
   - Altered mental status
   - Neurological deficits

2. Eosinophilia: A significant increase in eosinophils in the peripheral blood is often observed, which is a hallmark of allergic and parasitic infections.

3. Meningeal Signs: The presence of meningeal signs, such as Kernig's sign or Brudzinski's sign, may indicate meningitis.

Laboratory Criteria

1. Cerebrospinal Fluid (CSF) Analysis:
   - Eosinophilic Pleocytosis: A predominance of eosinophils in the CSF is a critical diagnostic feature.
   - Elevated Protein Levels: Increased protein concentration in the CSF may be noted.
   - Normal Glucose Levels: Unlike bacterial meningitis, glucose levels in the CSF are typically normal.

2. Serological Tests:
   - Detection of specific antibodies against Parastrongylus cantonensis can support the diagnosis, although these tests may not be universally available.

3. Molecular Techniques: Polymerase chain reaction (PCR) assays can be utilized to identify the presence of the parasite's DNA in CSF or other biological samples.

Epidemiological Criteria

1. Exposure History: A history of exposure to environments where the parasite is endemic, such as areas with freshwater snails (intermediate hosts) or consumption of contaminated food (e.g., raw or undercooked snails, slugs, or contaminated vegetables), is crucial for diagnosis.

2. Geographical Distribution: Knowledge of the geographical prevalence of Parastrongylus cantonensis can aid in the diagnostic process, as the infection is more common in tropical and subtropical regions.

Conclusion

The diagnosis of angiostrongyliasis due to Parastrongylus cantonensis (ICD-10 code B83.2) relies on a combination of clinical symptoms, laboratory findings, and epidemiological data. Clinicians must consider these criteria in conjunction with patient history and potential exposure to accurately diagnose and manage this parasitic infection. Early recognition and treatment are essential to prevent complications associated with the disease.

Angiostrongyliasis, specifically caused by Parastrongylus cantonensis, is a parasitic infection that primarily affects the central nervous system and is often associated with eosinophilic meningitis. The ICD-10 code B83.2 refers to this specific condition. Here, we will explore the standard treatment approaches for this infection, including diagnosis, management, and supportive care.

Overview of Angiostrongyliasis

Parastrongylus cantonensis, commonly known as the rat lungworm, is transmitted to humans through the consumption of contaminated food or water, particularly raw or undercooked snails and slugs. The infection can lead to severe neurological symptoms, including headaches, neck stiffness, and altered mental status, due to the migration of larvae to the central nervous system[1].

Diagnosis

Diagnosis of angiostrongyliasis typically involves:

• Clinical Evaluation: Assessment of symptoms such as fever, headache, and neurological signs.
• Serological Tests: Detection of antibodies against P. cantonensis in the blood or cerebrospinal fluid (CSF).
• CSF Analysis: Lumbar puncture may reveal eosinophilia, which is a hallmark of the infection[2].

Standard Treatment Approaches

1. Supportive Care

Supportive care is the cornerstone of treatment for angiostrongyliasis, as there is no specific antiparasitic therapy approved for this infection. Supportive measures include:

• Symptomatic Treatment: Management of symptoms such as pain relief with analgesics, anti-inflammatory medications, and corticosteroids to reduce inflammation in the central nervous system[3].
• Hydration: Ensuring adequate fluid intake to prevent dehydration, especially if the patient has gastrointestinal symptoms.
• Monitoring: Close observation for any progression of neurological symptoms, which may require hospitalization in severe cases[4].

2. Corticosteroids

Corticosteroids may be administered to reduce inflammation and swelling in the central nervous system. This can help alleviate symptoms and prevent complications associated with increased intracranial pressure[5]. The dosage and duration depend on the severity of the symptoms and the clinical judgment of the healthcare provider.

3. Antiparasitic Agents (Experimental)

While there is no universally accepted antiparasitic treatment for P. cantonensis, some studies have explored the use of drugs such as:

• Albendazole: This broad-spectrum anthelmintic has shown some efficacy in experimental settings, but its use in humans remains controversial and is not standard practice[6].
• Ivermectin: Similar to albendazole, ivermectin has been investigated for its potential effects against various parasitic infections, but its role in treating angiostrongyliasis is not well established[7].

4. Management of Complications

In cases where patients develop severe complications, such as seizures or significant neurological deficits, additional interventions may be necessary. This could include:

• Anticonvulsants: For patients experiencing seizures.
• Neurosurgical Intervention: In rare cases where there is significant mass effect or other complications requiring surgical management[8].

Conclusion

The management of angiostrongyliasis due to Parastrongylus cantonensis primarily focuses on supportive care and symptomatic relief, as there is no definitive antiparasitic treatment available. Corticosteroids may be beneficial in reducing inflammation, while monitoring for complications is crucial. As research continues, the understanding of effective treatments may evolve, but current approaches emphasize the importance of supportive care in managing this parasitic infection. If you suspect exposure or experience symptoms, it is essential to seek medical attention promptly.

References

1. [1] Overview of Angiostrongyliasis and its transmission.
2. [2] Diagnostic methods for Angiostrongyliasis.
3. [3] Supportive care measures in parasitic infections.
4. [4] Importance of monitoring in severe cases.
5. [5] Role of corticosteroids in managing inflammation.
6. [6] Experimental antiparasitic treatments.
7. [7] Investigational use of ivermectin.
8. [8] Management of neurological complications.