Chronic neuroangiostrongyliasis: case study of chronic presentations in Hawaii

This paper describes chronic features of neuroangiostrongyliasis (NAS), a long-term outcome of the disease that has not been adequately described. Current and past literature is predominantly limited to acute manifestations of NAS, and mention of chronic, ongoing clinical symptoms is usually limited...

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Bibliographic Details
Published in:Parasitology 2021-02, Vol.148 (2), p.221-226
Main Author: Meyer, Bernard C.
Format: Article
Language:English
Subjects:
Adult
Aged
Angiostrongylus cantonensis - physiology
Animals
Anxiety
Burning
Case studies
Chronic Disease - psychology
Chronic Disease - therapy
Employment
Female
Hawaii
Headaches
Humans
Illnesses
Infections
Insomnia
Male
Meningitis
Middle Aged
Muscles
Pain
Pain perception
Paresthesia
Patients
Questionnaires
Retention
Signs and symptoms
Skin
Sleep
Sleep disorders
Strongylida Infections - pathology
Strongylida Infections - physiopathology
Strongylida Infections - psychology
Strongylida Infections - therapy
Support groups
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Summary:This paper describes chronic features of neuroangiostrongyliasis (NAS), a long-term outcome of the disease that has not been adequately described. Current and past literature is predominantly limited to acute manifestations of NAS, and mention of chronic, ongoing clinical symptoms is usually limited to brief notes in a discussion of severe cases. This study investigated the long-term outcomes in ten individuals who were diagnosed with acute neuroangiostrongyliasis in Hawaii between 2009 and 2017. The study demonstrates a significant number of persons in Hawaii sustain residual symptoms for many years, including troublesome sensory paresthesia (abnormal spontaneous sensations of skin experienced as ‘burning, pricking, pins and needles’; also described as allodynia or hyperesthesia) and extremity muscle pains. As a consequence, employment and economic hardships, domestic relocations, and psychological impairments affecting personal relationships occurred. The study summarizes common features of chronic disease, sensory paresthesia and hyperesthesia, diffuse muscular pain, insomnia, and accompanying emotional distress; highlights the frequently unsuccessful endeavours of individuals struggling to find effective treatment; proposes pathogenic mechanisms responsible for prolonged illness including possible reasons for differences in disease presentation in Hawaii compared to Southeast Asia.
ISSN:0031-1820
1469-8161
DOI:10.1017/S0031182020001651