番茄社区

A woman and her adult son had antibodies to the parasite Angiostrongylus cantonensis after consuming raw centipedes purchased from a vegetable market in China, researchers found.

This marks the first report of the A. cantonensis parasite (often called "rat lungworm") potentially being transmitted through an intermediate centipede host, wrote Huijie Wang, MD, of Southern Medical University in Guangzhou, China, and colleagues in the .

"We don't typically hear of people eating raw centipedes, but apparently these two patients believed that raw centipedes would be good for their health," co-author Lingli Lu, MD, of Zhujiang Hospital in Guangzhou, China, said in a statement. "Instead it made them sick."

Wang's group wrote that humans typically are exposed to A. cantonensis through eating "raw or poorly cooked snails, slugs, monitor lizards, frogs, and fish" or vegetables or salads that were contaminated by these hosts. The parasite can cause angiostrongyliasis, a foodborne-parasitic disease, and can lead to eosinophilic meningitis or meningoencephalitis, the authors said.

While A. cantonensis is mainly found in China and Southeast Asia, the authors noted it has been detected around the globe, including parts of the U.S. -- prior research discovered A. cantonensis in the in Louisiana and in the invasive giant African land snail in south Florida.

The researchers examined two cases: a woman, age 78, who presented to the hospital with headache, drowsiness, and cognitive impairment. Analysis of her cerebrospinal fluid (CSF) indicated an increased number of eosinophils and antibodies to A. cantonensis. Her medical history revealed that she consumed raw centipedes on a number of occasions.

A few weeks later, the woman's son, age 46, complained of a "mild headache lasting longer than 20 days." Tests of his blood and CSF also revealed an increased number of eosinophils, as well as antibodies to A. cantonensis, the authors wrote. Both patients were treated with a 21-day course of albendazole (an anti-parasitic drug) and dexamethasone (a steroid).

They noted that the symptoms of both patients were "very light," and that changes in CSF were atypical, so the diagnosis could only be confirmed with the presence of A. cantonensis antibodies.

Researchers then set off to the market to find the smoking gun -- or centipede. They collected 20 centipedes from the same location, with an average of 56 larvae in each. Then they extracted the DNA and analyzed it, concluding that "both the etiological examination and the PCR analysis suggested that centipedes might be the hosts of A. cantonensis."

They bought 30 more centipedes and divided them into two groups -- 10 centipedes as a control and 20 that were infected with A. cantonensis. The control group tested negative, they said, but the centipedes in group 2 died as a result of infection, so the authors concluded they "remain uncertain whether the centipede is an intermediate host of A. cantonensis."

"This study shows why it's important to have physician scientists who can both treat patients and identify and investigate unusual cases that may have broader implications for public health," Regina Rabinovich, MD, president of the American Society for Tropical Medicine & Hygiene, said in a statement.