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Advice sought on treating Angiostrongylus costaricensis infection

Torsten Mark Kowal tmkowal at hondutel.hn
Thu Feb 28 10:37:57 EST 2002

Dear Sir/Madam,

I am a British forester resident in Honduras. I was recently operated on 
for abdominal/intestinal angiostrongyliasis due to infection of 
Angiostrongylus costaricensis. A 12 inch section of intestine was found to 
suffer granulomatous tissue reaction. I am under the supervision of Dr 
Nahim Nasralla of the Evangelical Hopsital, Siguatepeque <Nahimnaz at aol.com>

I am now recovering and seeking information on the best compound to 
eradicate any remaining larvae or adult nematodes from my body, but medical 
treatment I understand is notoriously difficult.  I really want to 
eliminate any further risk after traumatic surgery, which I wouldn't want 
to repeat.

I am taking albendazole (200 mg twice a day for 5 days) but understand that 
this is not the drug of choice for rather, Thiabendazole/Tiabendazole is 
the drug of choice against strongyloidiasis caused by Angiostrongylus 
costaricensis. But the latter is not available in Honduras and is known to 
cause severe side effects.

I believe Mebendazole can also act on the nematode, but only weakly. The 
experimental  anti-helmintic drug
cyclodepsipeptide PF1022A has also been studied, but I have no idea if this 
is approved and available.

In the absence of Thiabendazole, I believe that the Albendazole course 
could be followed by a course of Mebendazole.

Do you have any advice as to latest best practice in treating A. 
costaricensis and whether the Albendazole + Mebendazole treatment  is 
likely to be effective.

Best regards,

Mr Torsten Mark Kowal

Dirección postal: Apartado 189, Siguatepeque, Honduras, América Central.
Email: Torsten Mark Kowal tmkowal at bigfoot.com y tmkowal at hondutel.hn
Tels.:  + (504) -7730686; + (504)-7734862;   Fax.   + (504) -7734863

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