Alicata disease: neuroinfestation by Angiostrongylus cantonensis in Recife, Pernambuco, Brazil.

Dra. Maria Lúcia Brito Ferreira – Rua Neto de Mendonça 230 / 802 52050-100 Recife PE Brasil. E-mail: [email protected] Angiostrongylus cantonensis, is a nematode in the Secernentea class, Strongylidae order, Metastrongylidæ superfamily and Angiostrongylidæ family, and is the most common cause of human eosinophilic meningitis worldwide. This parasite has rats and other mammals as definitive hosts and snails, freshwater shrimp, fish, frogs and monitor lizards as intermediate hosts. Mammals are infected by ingestion of intermediate hosts and raw/undercooked snails or vegetables, containing third-stage larvae. Once infested, the larvae penetrate the vasculature of the intestinal tract and promote an inflammatory reaction with eosinophilia and lymphocytosis. This produces rupture of the bloodbrain barrier, changes to nervous tissue and damage to the Purkinje cells in the cerebellum, thereby promoting eosinophilic meningoencephalitis or Alicata disease. A. cantonensis has been found in Southeast Asia and the South Pacific, where it is endemic, as well as in Africa, India, Caribbean, Australia, North America, Jamaica, Haiti, Cuba, Puerto Rico and Brazil.