{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:11:23Z","timestamp":1791825083565,"version":"4.3.4"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Angiostrongylus cantonensis is the main causative agent for eosinophilic meningoencephalitis in humans. Larvae are rarely found in the cerebral spinal fluid (CSF). Consequently, serology and DNA detection represent important diagnostic tools. However, interpretation of the results obtained from these tools requires that more extensive accuracy studies be conducted. The aim of the present study is to update guidelines for diagnosis and case definitions of neuroangiostrongyliasis (NA) as provided by a working group of a recently established International Network on Angiostrongyliasis. A literature review, a discussion regarding criteria and diagnostic categories, recommendations issued by health authorities in China and an expert panel in Hawaii (USA), and the experience of Thailand were considered. Classification of NA cases and corresponding criteria are proposed as follows: minor (exposure history, positive serology, and blood eosinophilia); major (headache or other neurological signs or symptoms, CSF eosinophilia); and confirmatory (parasite detection in tissues, ocular chambers, or CSF, or DNA detection by PCR and sequencing). In addition, diagnostic categories or suspected, probable, and confirmatory are proposed. Updated guidelines should improve clinical study design, epidemiological surveillance, and the proper characterization of biological samples. Moreover, the latter will further facilitate accuracy studies of diagnostic tools for NA to provide better detection and treatment.<\/jats:p>","DOI":"10.3390\/pathogens12040624","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T02:05:31Z","timestamp":1682042731000},"page":"624","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Neuroangiostrongyliasis: Updated Provisional Guidelines for Diagnosis and Case Definitions"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-0061","authenticated-orcid":false,"given":"Carlos","family":"Graeff-Teixeira","sequence":"first","affiliation":[{"name":"Center for Health Sciences, Universidade Federal do Esp\u00edrito Santo, Vit\u00f3ria 29075-910, ES, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittisak","family":"Sawanyawisuth","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Lv","sequence":"additional","affiliation":[{"name":"Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai 200025, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Sears","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaily Gonz\u00e1lez","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Reference National Parasitology Laboratory, Instituto de Medicina Tropical \u201cPedro Kour\u00ed\u201d (IPK), Havana 11400, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilda Hern\u00e1ndez","family":"\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Reference National Parasitology Laboratory, Instituto de Medicina Tropical \u201cPedro Kour\u00ed\u201d (IPK), Havana 11400, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Casanova","family":"Arias","sequence":"additional","affiliation":[{"name":"Reference National Parasitology Laboratory, Instituto de Medicina Tropical \u201cPedro Kour\u00ed\u201d (IPK), Havana 11400, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2307-1314","authenticated-orcid":false,"given":"Leticia Karolini Walger","family":"Schultz","sequence":"additional","affiliation":[{"name":"Center for Health Sciences, Universidade Federal do Esp\u00edrito Santo, Vit\u00f3ria 29075-910, ES, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2007-7198","authenticated-orcid":false,"given":"Alicia","family":"Rojas","sequence":"additional","affiliation":[{"name":"Departamento de Parasitologia, Facultad de Microbiologia, Universidad de Costa Rica, San Jose 11501-2060, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3968-1731","authenticated-orcid":false,"given":"John","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI 96720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Jarvi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI 96720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenton","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0065-308X(08)60366-8","article-title":"Biology and distribution of the rat lungworm, Angiostrongylus cantonensis, and its relationship to eosinophilic meningoencephalitis and other neurological disorders of man and animals","volume":"3","author":"Alicata","year":"1965","journal-title":"Adv. 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