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Baylisascaris procyonis

Epidemiology: 1) common roundworm found in the small intestine of raccoons in North America, Japan & Germany. - infests 68-82% of some raccoon populations 2) adult worms may be 15-20 cm in length & 1 cm in width 3) humans become infected by ingesting soil or other material contaminated with raccoon feces containing eggs 4) young children at greatest risk 5) case reports from Chicago & Los Angeles in 2000 - 2 cases in Los Angeles County 2024 [7] 6) case report from King County Washington in 2017 [6] 7) CDC report in 2024: - 37 cases of Baylisascaris procyonis infection in North America - 33 cases in the U.S., 4 in Canada - median age of 1.6 years, 82% were male - 18% of cases resulted in death - geophagia was mentioned in 55% of cases, 33% with developmental disabilities [7] Pathology: 1) response of the paratenic host to the invading larvae involvings walling it off or killing it 2) collateral damage to tissue occurs 3) severe of fatal encephalitis (neural larva migrans) in birds & mammals, including humans 4) visceral larval migrans 5) ocular larval migrans Clinical manifestations: - skin irritations from larvae migrating within the skin - respiratory discomfort - hepatomegaly - fever - nausea - encephalomyelitis - lethargy - incoordination - visual impairment - severe neurological signs - seizures - coma - death Laboratory: - microscopic examinaton of affected tissue Management: 1) prognosis: poor 2) albendazole - 20-40 mg/kg/day for 1-4 weeks - not larvicidal - no effect on migrating larvae - used in case report without success - laser surgery has been successfully performed to kill larvae present in the retina but the damage caused by the migrating larvae is irreversible - treatment with glucocorticoids is mainly supportive intended to decrease the inflammatory reaction

General

Baylisascaris

Properties

KINGDOM: animal PHYLUM: helminth

References

  1. Wikipedia: Baylisascaris http://en.wikipedia.org/wiki/Baylisascaris
  2. Centers for Disease Control and Prevention DPDx: Parasites and Health: Baylisascaris http://dpd.cdc.gov/dpdx/html/Baylisascariasis.htm
  3. Centers for Disease Control and Prevention Parasites - Baylisascaris infection http://www.cdc.gov/parasites/baylisascaris/
  4. Huff DS et al Case 4 the First Fatal Baylisascaris Infection in Humans: An Infant with Eosinophilic Meningoencephalitis Fetal & Pediatric Pathology 1984, 2(3):345-352 http://informahealthcare.com/doi/abs/10.3109/15513818409022268
  5. Morbidity & Mortality Weekly Report 50:51&52, Jan 4, 2002
  6. Kawakami V, Casto A, Natarajan N et al. Notes from the field: Baylisascaris procyonis encephalomyelitis in a toddler - King County, Washington, 2017. MMWR Morb Mortal Wkly Rep 2018 Jan 19; 67:79. PMID: 29346337 Free PMC Article https://www.cdc.gov/mmwr/volumes/67/wr/mm6702a6.htm
  7. Fiore K What to Know About 'Raccoon Roundworm' Stay away from raccoon latrines. MedPage Today September 19, 2024 https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/112029