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 reported cases in other countries were adults and their clinical manifestations were different from those in children. Studies on special clinical characteristics of angiostrongyliasis cantonensis among 82 children in Taiwan were performed; 38 (46.3%) were male and 44 (53.7%) were females. 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 1/3 (30.5%) of the total cases the clinical presentation 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 6th and 7th cranial neuropathy associated with the disease were 19.5% and 11.0% respectively. Ophthalmologic fundoscopy showed 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 (> 10000/cu.mm) and eosinophilia (>10%); the percentages were 82.9% and 84.1% respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 82 cases were 41.5%; 141 worms were collected from 1 female using a pumping method. In the recent 2 years albendazole and levamisole were used clinically with favorable results. (authors modified)