The disease caused by nematode parasites of the genus Baylisascaris; migrating larvae of the raccoon parasite B. procyonis can cause a severe disease of the central nervous system in a variety of wild and domestic animal species and, rarely, in humans; human disease has been manifested as either a fatal eosinophilic meningoencephalitis or a diffuse unilateral subacute neuroretinitis.
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Although this devastating disease is rare, lack of effective treatment and the widespread distribution of raccoons in close association with humans make baylisascariasis a disease that seriously affects public health.
After consultation with CDC, empirical treatment with oral albendazole (25 mg/kg/day) and intravenous steroids for suspected baylisascariasis was initiated on April 29, while B.
(2003) Toxocariasis and baylisascariasis. In DJ Richardson and PJ Krause (Editors), North American Parasitic Zoonoses, pp.
(6.) The Medical Letter (Drugs for Parasitic Infections) Files/MedLetter/ Baylisascariasis.pdf
Although documented cases of human baylisascariasis remain relatively uncommon, environmental contamination by infected raccoons suggests that the risk of exposure and human infection is substantial.
In Santa Barbara County, a baylisascariasis case was reported in a toddler in 2002 (1,5); raccoon roundworm consistently infects >80% of raccoons (6,7); and latrines are abundant in residential areas (J.F.
Baylisascariasis is not a nationally notifiable disease in the United States, and little is known about how commonly it occurs or the range of clinical disease in humans.
Baylisascariasis. (accessed May 1, 2005).
The clinical spectrum of baylisascariasis is not fully understood.
Because of the patient's rapid neurologic decline, we initiated albendazole (20 mg/kg/d, given in doses every 12 h) and dexamethasone (4 mg every 6 h) on day 17 for empiric reatment of baylisascariasis or other helminth infection; we also initiated empiric fluconazole and doxycycline.
Thirty severe or fatal human cases of baylisascariasis have been reported (5-7; K.R.