L'angiostrongylose humaine : une maladie tropicale négligée

Human angiostrongyliasis or nervous angiostrongyliasis is a rare parasitic disease linked to a nematode, Angiostrongylus cantonensis. Humans are accidental hosts and develop a neurological disease characterized by an eosinophilic meningitis and / or encephalitis with a favorable outcome in adults but sometimes poor outcome in children. The diagnosis relies on the combination of neurological signs with eosinophilia in CSF in an individual living or returning from an endemic area. The microbiological diagnosis is not always possible, and relies on serodiagnosis in blood or CSF, where sensitivity is better, but also on RT-PCR performed in CSF available for some years. Treatment is not standardized, and severe forms justify the combination of a corticosteroid and albendazole. If the disease is scattered in tropical regions, it is particularly common in China, Taiwan, Thailand and the Pacific Islands. It was also found sparsely in the Indian Ocean Islands, but also in Jamaica and Brazil. The mode of transmission is variable from one location to another. In China, Thailand and the Pacific Ocean, contamination often occurs through the consumption of undercooked shellfish. In the Indian Ocean, Taiwan, Brazil and Hawaï, the main route of transmission is direct or indirect ingestion of saliva of the giant African snail (Achatina fulica). This species considered as invasive, is present in most tropical regions of the globe. Clinicians and parasitology specialists must systematically raise this etiology in front of an eosinophilic meningitis in a patient table or back living in the tropics.