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Chronic neuroangiostrongyliasis: case study of chronic presentations in Hawaii

Published online by Cambridge University Press:  10 September 2020

Bernard C. Meyer Open the ORCID record for Bernard C. Meyer [Opens in a new window]
Bernard C. Meyer*
Affiliation:
East Maui Community and Tropical Medicine, PO Box 756, Hana, Hawaii96713, USA
*
Author for correspondence: Bernard C. Meyer, E-mail: hanablues@gmail.com
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Abstract

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.

Keywords

AllodyniaAngiostrongylus cantonensis (A. cantonensis)chronicHawaiihyperesthesiaparesthesianeuroangiostrongyliasis (NAS)Parmarion martensirat lungworm
Type
Research Article
Information
Parasitology , Volume 148 , Special Issue 2: 6th International Workshop on Angiostrongylus and Angiostrongyliasis, Hilo, Hawai'i, USA, January, 2020 , February 2021 , pp. 221 - 226
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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