An Overview of Angiostrongylus cantonensis: Systematics, Morphology, Life Cycle, Human Infection, Diagnosis and Therapy
Abhisek Mishra *
Division of Medicine, ICAR- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India.
*Author to whom correspondence should be addressed.
Abstract
Angiostrongylus cantonensis, commonly known as the rat lungworm, is a food-borne and environmentally transmitted nematode of increasing global importance. The parasite is maintained primarily in rat definitive hosts and gastropod intermediate hosts, while humans and several other vertebrates act as accidental hosts in whom larval migration to the central nervous system produces neuroangiostrongyliasis, classically expressed as eosinophilic meningitis or meningoencephalitis. In recent decades, expanded geographic dispersal, changing food systems, invasive snail populations, wider recognition of imported disease, and improved molecular tools have brought renewed attention to this helminth. This review synthesises current knowledge on the parasite’s systematics, morphology, developmental biology, transmission ecology, human infection, diagnosis and therapy. Particular attention is given to ongoing taxonomic debates, the morphological features of adults and larval stages that are relevant to diagnosis and experimental work, the ecological complexity of intermediate and paratenic host networks, and the mechanisms by which larval neurotropism leads to inflammatory neurological disease in humans. Diagnostic progress has been driven by more rigorous clinical case definitions and by nucleic acid amplification assays applied to cerebrospinal fluid and other specimens, although access and standardisation remain uneven. Therapeutic management continues to rely on supportive care, repeated lumbar puncture when indicated, and corticosteroids, with albendazole used selectively, usually in combination with steroids, in carefully chosen clinical contexts. Despite substantial advances, important gaps remain in surveillance, exposure quantification, taxonomy–genotype concordance, and high-quality therapeutic trials. A consolidated appraisal of these themes is essential for improving case recognition, guiding rational management, and refining future research priorities in this neglected but increasingly consequential zoonosis.
Keywords: Angiostrongylus cantonensis, angiostrongyliasis, eosinophilic meningitis, rat lungworm, albendazole, corticosteroids