{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:55:11Z","timestamp":1792616111467,"version":"4.5.0"},"reference-count":80,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Although more than 30 case reports of eosinophilic meningitis have been attributed to\n                    <jats:italic>Angiostrongylus cantonensis<\/jats:italic>\n                    (\n                    <jats:italic>A. cantonensis<\/jats:italic>\n                    ) in India, only three have been microbiologically confirmed (via polymerase chain reaction [PCR] or immunoblot testing). In seven ocular infections and two brain abscesses reported,\n                    <jats:italic>A. cantonensis<\/jats:italic>\n                    was identified on the basis of the morphology of recovered worms. Here, five cases of\n                    <jats:italic>Angiostrongylus<\/jats:italic>\n                    eosinophilic meningitis (AEM) in children and adults are reported, diagnosed via the detection of\n                    <jats:italic>A. cantonensis<\/jats:italic>\n                    DNA in cerebrospinal fluid using the AcanR3990 quantitative PCR (National Institutes of Health, Bethesda, MD). All patients responded to management with steroids and albendazole. When AEM cases reported from India were reviewed and mapped, the majority were reported from southern Indian states. Managing and preventing this emerging zoonosis in these areas requires 1) access to accurate and timely diagnostics, 2) increasing awareness among clinicians, and 3) risk assessment with public health officials on acquiring infections from water and food contaminated by gastropods and other paratenic hosts.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0166","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T16:20:54Z","timestamp":1765470054000},"page":"279-283","source":"Crossref","is-referenced-by-count":1,"title":["Detecting Angiostrongylus cantonensis Eosinophilic Meningitis with Highly Sensitive Quantitative Polymerase Chain Reaction\u2014Report of Five Cases in Southern India"],"prefix":"10.4269","volume":"114","author":[{"given":"Kollencheri Puthenveettil","family":"Vinayan","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology, Amrita Institute of Medical Sciences And Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishakh","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Amrita Institute of Medical Sciences And Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra","family":"Rao S","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiren George","family":"Koshy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sri Chitra Tirunal Institute of Medical Sciences, Trivandrum, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sapna Erat","family":"Sreedharan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sri Chitra Tirunal Institute of Medical Sciences, Trivandrum, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teena","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"David","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalitha","family":"Biswas","sequence":"additional","affiliation":[{"name":"Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Ponekkara Kochi, Kerala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon John","family":"Israel","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malathi","family":"Manuel","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sitara Swarna Rao","family":"Ajjampur","sequence":"additional","affiliation":[{"name":"The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"One Health","first-page":"100426","article-title":"Paratenic hosts of Angiostrongylus cantonensis and their relation to human neuroangiostrongyliasis globally","volume":"15","author":"Turck","year":"2022"},{"key":"b2","series-title":"PLoS One","first-page":"e0209813","article-title":"Water transmission potential of Angiostrongylus cantonensis: Larval viability and effectiveness of rainwater catchment sediment filters","volume":"14","author":"Howe","year":"2019"},{"key":"b3","series-title":"Trop Doct","first-page":"76","article-title":"Human ocular angiostrongyliasis: A literature review","volume":"41","author":"Diao","year":"2011"},{"key":"b4","series-title":"Pathogens","first-page":"851","article-title":"An overview of Angiostrongylus cantonensis (Nematoda: Angiostrongylidae), an emerging cause of human angiostrongylosis on the Indian subcontinent","volume":"12","author":"Pandian","year":"2023"},{"key":"b5","series-title":"Lancet Infect Dis","first-page":"621","article-title":"Human angiostrongyliasis","volume":"8","author":"Wang","year":"2008"},{"key":"b6","series-title":"Clin Infect Dis","first-page":"e1594","article-title":"AcanR3990 qPCR: A novel, highly sensitive, bioinformatically-informed assay to detect Angiostrongylus cantonensis infections","volume":"73","author":"Sears","year":"2021"},{"key":"b7","series-title":"Vet Parasitol","first-page":"160","article-title":"Highly sensitive multiplex PCR for simultaneous detection and discrimination of Dirofilaria immitis and Dirofilaria repens in canine peripheral blood","volume":"172","author":"Gioia","year":"2010"},{"key":"b8","series-title":"Am J Med","first-page":"217","article-title":"Eosinophilic meningitis","volume":"114","author":"Lo Re","year":"2003"},{"key":"b9","series-title":"Curr Opin Infect Dis","first-page":"399","article-title":"Angiostrongylus cantonensis in travelers: Clinical manifestations, diagnosis, and treatment","volume":"31","author":"Ansdell","year":"2018"},{"key":"b10","series-title":"Hawaii J Med Public Health","first-page":"35","article-title":"Clinical aspects of eosinophilic meningitis and Meningoencephalitis caused by Angiostrongylus cantonensis, the rat lungworm","volume":"72","author":"Murphy","year":"2013"},{"key":"b11","series-title":"Clin Infect Dis","first-page":"1293","article-title":"Clinical efficacy and safety of albendazole and other benzimidazole anthelmintics for rat lungworm disease (Neuroangiostrongyliasis): A systematic analysis of clinical reports and animal studies","volume":"74","author":"Jacob","year":"2022"},{"key":"b12","series-title":"Parasitology","first-page":"227","article-title":"Guidelines for the diagnosis and treatment of neuroangiostrongyliasis: Updated recommendations","volume":"148","author":"Ansdell","year":"2021"},{"key":"b13","series-title":"Southeast Asian J Trop Med Public Health","first-page":"498","article-title":"Occurrence of the infective stage of Angiostrongylus cantonensis in the yellow tree monitor (Varanus bengalensis) in five Provinces of Thailand","volume":"25","author":"Radomyos","year":"1994"},{"key":"b14","series-title":"Indian Pediatr","first-page":"187","article-title":"Eosinophilic meningitis in a toddler","volume":"58","author":"Raveendrakumar","year":"2021"},{"key":"b15","series-title":"Neurol India","first-page":"414","article-title":"Severe form of radiculo-myelo-neuropathy with meningo-encephalitis secondary to Angiostrongylus cantonensis infection: Unusual corpus callosal lesions and serial magnetic resonance imaging findings","volume":"61","author":"Nalini","year":"2013"},{"key":"b16","series-title":"Int J Contemp Pediatr","first-page":"959","article-title":"A rare case of eosinophilic meningitis","volume":"10","author":"Dcruz","year":"2023"},{"key":"b17","series-title":"Acta Neurol Belg","first-page":"2051","article-title":"Dysesthesias and migratory myalgias: Clinical clues to suspect neuroangiostrongyliasis","volume":"124","author":"Vysakha","year":"2024"},{"key":"b18","series-title":"Pediatr Neurol","first-page":"9","article-title":"Clinical characteristics and treatment outcome of eosinophilic meningoencephalitis in South Indian children: Experience from a prospective registry","volume":"147","author":"Vinayan","year":"2023"},{"key":"b19","series-title":"Emerg Infect Dis","first-page":"1532","article-title":"Eosinophilic meningitis and intraocular infection caused by Dirofilaria sp. genotype Hongkong","volume":"27","author":"Jyotsna","year":"2021"},{"key":"b20","series-title":"Hawaii J Med Public Health","first-page":"28","article-title":"Angiostrongyliasis in Thailand: Epidemiology and laboratory investigations","volume":"72","author":"Eamsobhana","year":"2013"},{"key":"b21","article-title":"Study Finds Repeated Waves of Giant African Snail Invasion in Kerala.","author":"Naha","year":"2020"},{"key":"b22","series-title":"Bull Calcutta Sch Trop Med","first-page":"38","article-title":"Angiostrongylus cantonensis in India","volume":"14","author":"Parmeter","year":"1966"},{"key":"b23","series-title":"Bull Haffkine","first-page":"38","article-title":"Study of a focus of Angiostrongylus cantonensis in Greater Bombay","volume":"9","author":"Sharma","year":"1981"},{"key":"b24","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1015","article-title":"Angiostrongylus cantonensis abscess in the brain","volume":"54","author":"Purohit","year":"1991"},{"key":"b25","series-title":"Ann Indian Acad Neurol","first-page":"217","article-title":"Case series of eosinophilic meningoencephalitis from South India","volume":"9","author":"Parameswaran","year":"2006"},{"key":"b26","series-title":"Indian J Med Microbiol","first-page":"220","article-title":"Eosinophilic meningitis due to Angiostrongylus cantonensis.","volume":"24","author":"Vishad","year":"2006"},{"key":"b27","series-title":"J Trop Pediatr","first-page":"223","article-title":"Ocular angiostrongyliasis in a child\u2014First case report from India","volume":"52","author":"Malhotra","year":"2006"},{"key":"b28","series-title":"Clin Exp Ophthalmol","first-page":"493","article-title":"Chemo-paralysis for the removal of a live intraocular worm in ocular angiostrongyliasis","volume":"34","author":"Mehta","year":"2006"},{"key":"b29","series-title":"BMJ Case Rep","first-page":"bcr2007122093","article-title":"Eosinophilic meningitis and an ocular worm in a patient from Kerala, south 333 India","volume":"2009","author":"Baheti","year":"2009"},{"key":"b30","series-title":"J Clin Diagn Res","first-page":"734","article-title":"An interesting case of eosinophilic meningitis","volume":"7","author":"Pai","year":"2013"},{"key":"b31","series-title":"J Clin Imaging Sci","first-page":"76","article-title":"Unusual larva in the CSF and unique MRI findings in a case of eosinophilic meningitis","volume":"4","author":"Rai","year":"2014"},{"key":"b32","series-title":"Indian J Med Microbiol","first-page":"154","article-title":"Eosinophilic meningitis: A case series and review of literature of Angiostrongylus cantonensis and Gnathostoma spinigerum","volume":"33","author":"Shah","year":"2015"},{"key":"b33","series-title":"Neurol India","first-page":"1166","article-title":"Eosinophilic meningitis caused by consumption of meat of monitor lizard (Varanus bengalensis)","volume":"66","author":"Johny","year":"2018"},{"key":"b34","series-title":"J AAPOS","first-page":"119","article-title":"Angiostrongylus\u2014A technique for removing a rare parasite from the cornea of a child","volume":"23","author":"Sen","year":"2019"},{"key":"b35","series-title":"Indian J Ophthalmol","first-page":"158","article-title":"Angiostrongylus cantonensis in anterior chamber","volume":"67","author":"Tiwari","year":"2019"},{"key":"b36","series-title":"Ann Indian Acad Neurol","first-page":"108","article-title":"Eosinophilic meningitis: Report of three cases from a hilly area in Kerala","volume":"22","author":"Varghese","year":"2019"},{"key":"b37","series-title":"Asian J Pharm Health Sci","first-page":"2307","article-title":"Eosinophilic meningitis: A case report","volume":"10","author":"Naja","year":"2020"},{"key":"b38","series-title":"Ann Indian Acad Neurol","first-page":"757","article-title":"A curious case of eosinophilic meningitis in a family in Southern India","volume":"25","author":"Nambiar","year":"2022"},{"key":"b39","series-title":"Indian J Pathol Microbiol","first-page":"420","article-title":"Eosinophilic meningitis due to A. cantonensis revealed at autopsy","volume":"65","author":"Chaudhari","year":"2022"},{"key":"b40","series-title":"Neurol India","first-page":"892","article-title":"A case series of eosinophilic meningitis from Kerala","volume":"73","author":"George","year":"2025"},{"key":"b1","series-title":"One Health","first-page":"100426","article-title":"Paratenic hosts of Angiostrongylus cantonensis and their relation to human neuroangiostrongyliasis globally","volume":"15","author":"Turck","year":"2022"},{"key":"b2","series-title":"PLoS One","first-page":"e0209813","article-title":"Water transmission potential of Angiostrongylus cantonensis: Larval viability and effectiveness of rainwater catchment sediment filters","volume":"14","author":"Howe","year":"2019"},{"key":"b3","series-title":"Trop Doct","first-page":"76","article-title":"Human ocular angiostrongyliasis: A literature review","volume":"41","author":"Diao","year":"2011"},{"key":"b4","series-title":"Pathogens","first-page":"851","article-title":"An overview of Angiostrongylus cantonensis (Nematoda: Angiostrongylidae), an emerging cause of human angiostrongylosis on the Indian subcontinent","volume":"12","author":"Pandian","year":"2023"},{"key":"b5","series-title":"Lancet Infect Dis","first-page":"621","article-title":"Human angiostrongyliasis","volume":"8","author":"Wang","year":"2008"},{"key":"b6","series-title":"Clin Infect Dis","first-page":"e1594","article-title":"AcanR3990 qPCR: A novel, highly sensitive, bioinformatically-informed assay to detect Angiostrongylus cantonensis infections","volume":"73","author":"Sears","year":"2021"},{"key":"b7","series-title":"Vet Parasitol","first-page":"160","article-title":"Highly sensitive multiplex PCR for simultaneous detection and discrimination of Dirofilaria immitis and Dirofilaria repens in canine peripheral blood","volume":"172","author":"Gioia","year":"2010"},{"key":"b8","series-title":"Am J Med","first-page":"217","article-title":"Eosinophilic meningitis","volume":"114","author":"Lo Re","year":"2003"},{"key":"b9","series-title":"Curr Opin Infect Dis","first-page":"399","article-title":"Angiostrongylus cantonensis in travelers: Clinical manifestations, diagnosis, and treatment","volume":"31","author":"Ansdell","year":"2018"},{"key":"b10","series-title":"Hawaii J Med Public Health","first-page":"35","article-title":"Clinical aspects of eosinophilic meningitis and Meningoencephalitis caused by Angiostrongylus cantonensis, the rat lungworm","volume":"72","author":"Murphy","year":"2013"},{"key":"b11","series-title":"Clin Infect Dis","first-page":"1293","article-title":"Clinical efficacy and safety of albendazole and other benzimidazole anthelmintics for rat lungworm disease (Neuroangiostrongyliasis): A systematic analysis of clinical reports and animal studies","volume":"74","author":"Jacob","year":"2022"},{"key":"b12","series-title":"Parasitology","first-page":"227","article-title":"Guidelines for the diagnosis and treatment of neuroangiostrongyliasis: Updated recommendations","volume":"148","author":"Ansdell","year":"2021"},{"key":"b13","series-title":"Southeast Asian J Trop Med Public Health","first-page":"498","article-title":"Occurrence of the infective stage of Angiostrongylus cantonensis in the yellow tree monitor (Varanus bengalensis) in five Provinces of Thailand","volume":"25","author":"Radomyos","year":"1994"},{"key":"b14","series-title":"Indian Pediatr","first-page":"187","article-title":"Eosinophilic meningitis in a toddler","volume":"58","author":"Raveendrakumar","year":"2021"},{"key":"b15","series-title":"Neurol India","first-page":"414","article-title":"Severe form of radiculo-myelo-neuropathy with meningo-encephalitis secondary to Angiostrongylus cantonensis infection: Unusual corpus callosal lesions and serial magnetic resonance imaging findings","volume":"61","author":"Nalini","year":"2013"},{"key":"b16","series-title":"Int J Contemp Pediatr","first-page":"959","article-title":"A rare case of eosinophilic meningitis","volume":"10","author":"Dcruz","year":"2023"},{"key":"b17","series-title":"Acta Neurol Belg","first-page":"2051","article-title":"Dysesthesias and migratory myalgias: Clinical clues to suspect neuroangiostrongyliasis","volume":"124","author":"Vysakha","year":"2024"},{"key":"b18","series-title":"Pediatr Neurol","first-page":"9","article-title":"Clinical characteristics and treatment outcome of eosinophilic meningoencephalitis in South Indian children: Experience from a prospective registry","volume":"147","author":"Vinayan","year":"2023"},{"key":"b19","series-title":"Emerg Infect Dis","first-page":"1532","article-title":"Eosinophilic meningitis and intraocular infection caused by Dirofilaria sp. genotype Hongkong","volume":"27","author":"Jyotsna","year":"2021"},{"key":"b20","series-title":"Hawaii J Med Public Health","first-page":"28","article-title":"Angiostrongyliasis in Thailand: Epidemiology and laboratory investigations","volume":"72","author":"Eamsobhana","year":"2013"},{"key":"b21","article-title":"Study Finds Repeated Waves of Giant African Snail Invasion in Kerala.","author":"Naha","year":"2020"},{"key":"b22","series-title":"Bull Calcutta Sch Trop Med","first-page":"38","article-title":"Angiostrongylus cantonensis in India","volume":"14","author":"Parmeter","year":"1966"},{"key":"b23","series-title":"Bull Haffkine","first-page":"38","article-title":"Study of a focus of Angiostrongylus cantonensis in Greater Bombay","volume":"9","author":"Sharma","year":"1981"},{"key":"b24","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1015","article-title":"Angiostrongylus cantonensis abscess in the brain","volume":"54","author":"Purohit","year":"1991"},{"key":"b25","series-title":"Ann Indian Acad Neurol","first-page":"217","article-title":"Case series of eosinophilic meningoencephalitis from South India","volume":"9","author":"Parameswaran","year":"2006"},{"key":"b26","series-title":"Indian J Med Microbiol","first-page":"220","article-title":"Eosinophilic meningitis due to Angiostrongylus cantonensis.","volume":"24","author":"Vishad","year":"2006"},{"key":"b27","series-title":"J Trop Pediatr","first-page":"223","article-title":"Ocular angiostrongyliasis in a child\u2014First case report from India","volume":"52","author":"Malhotra","year":"2006"},{"key":"b28","series-title":"Clin Exp Ophthalmol","first-page":"493","article-title":"Chemo-paralysis for the removal of a live intraocular worm in ocular angiostrongyliasis","volume":"34","author":"Mehta","year":"2006"},{"key":"b29","series-title":"BMJ Case Rep","first-page":"bcr2007122093","article-title":"Eosinophilic meningitis and an ocular worm in a patient from Kerala, south 333 India","volume":"2009","author":"Baheti","year":"2009"},{"key":"b30","series-title":"J Clin Diagn Res","first-page":"734","article-title":"An interesting case of eosinophilic meningitis","volume":"7","author":"Pai","year":"2013"},{"key":"b31","series-title":"J Clin Imaging Sci","first-page":"76","article-title":"Unusual larva in the CSF and unique MRI findings in a case of eosinophilic meningitis","volume":"4","author":"Rai","year":"2014"},{"key":"b32","series-title":"Indian J Med Microbiol","first-page":"154","article-title":"Eosinophilic meningitis: A case series and review of literature of Angiostrongylus cantonensis and Gnathostoma spinigerum","volume":"33","author":"Shah","year":"2015"},{"key":"b33","series-title":"Neurol India","first-page":"1166","article-title":"Eosinophilic meningitis caused by consumption of meat of monitor lizard (Varanus bengalensis)","volume":"66","author":"Johny","year":"2018"},{"key":"b34","series-title":"J AAPOS","first-page":"119","article-title":"Angiostrongylus\u2014A technique for removing a rare parasite from the cornea of a child","volume":"23","author":"Sen","year":"2019"},{"key":"b35","series-title":"Indian J Ophthalmol","first-page":"158","article-title":"Angiostrongylus cantonensis in anterior chamber","volume":"67","author":"Tiwari","year":"2019"},{"key":"b36","series-title":"Ann Indian Acad Neurol","first-page":"108","article-title":"Eosinophilic meningitis: Report of three cases from a hilly area in Kerala","volume":"22","author":"Varghese","year":"2019"},{"key":"b37","series-title":"Asian J Pharm Health Sci","first-page":"2307","article-title":"Eosinophilic meningitis: A case report","volume":"10","author":"Naja","year":"2020"},{"key":"b38","series-title":"Ann Indian Acad Neurol","first-page":"757","article-title":"A curious case of eosinophilic meningitis in a family in Southern India","volume":"25","author":"Nambiar","year":"2022"},{"key":"b39","series-title":"Indian J Pathol Microbiol","first-page":"420","article-title":"Eosinophilic meningitis due to A. cantonensis revealed at autopsy","volume":"65","author":"Chaudhari","year":"2022"},{"key":"b40","series-title":"Neurol India","first-page":"892","article-title":"A case series of eosinophilic meningitis from Kerala","volume":"73","author":"George","year":"2025"}],"container-title":["The American Journal of Tropical Medicine and 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