Title of article :
Eosinophilic meningitis caused byAngiostrongylus cantonensis: report of 17 cases
Author/Authors :
Hung-chin Tsai، نويسنده , , Yung-ching Liu، نويسنده , , Calvin M. Kunin، نويسنده , , Susan Shin-Jung Lee، نويسنده , , Yao-shen Chen، نويسنده , , Hsi-Hsun Lin، نويسنده , , Tsung-Hung Tsai، نويسنده , , Wei-Ru Lin، نويسنده , , Chun-Kai Huang، نويسنده , , Muh-Yong Yen، نويسنده , , Chuan-Min Yen، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2001
Pages :
6
From page :
109
To page :
114
Abstract :
Purpose To describe two outbreaks of Angiostrongylus cantonensisinfection that occurred in Kaohsiung, Taiwan, during 1998 and 1999, and to characterize the source of the outbreaks and the clinical manifestations of the disease. Subjects and methods We performed a retrospective cohort study among Thai laborers with eosinophilic meningitis who ate raw snails (Ampullarium canaliculatus), as well as an environmental surveillance of larvae in snails. Results We enrolled 17 Thai laborers in whom severe headache and eosinophilia developed within 4 to 23 days after eating raw snails. Twelve (71%) developed eosinophilic meningitis. Third-stage larvae were found in the cerebrospinal fluids of 2 patients and in all 12 tested snails. Specific antibodies to A. cantonensiswere detected in serum from 16 of the patients and in cerebrospinal fluid from 5 of the patients. Central nervous system manifestations included headache (n = 17 [100%]), fever (n = 11 [65%]), Brudzinski’s sign/stiff neck (n = 11 [65%]), hyperesthesia (n = 3 [18%]), cranial nerve palsy (n = 2 [12%]), diplopia (n = 2 [12%]), and ataxia (n = 1 [6%]). Laboratory findings included peripheral eosinophilia (n = 15 [88%]) and cerebrospinal fluid eosinophilia (n = 12 [71%]); elevated immunoglobulin (Ig) E levels (n = 13 [100%]); and transient increases in white blood cell count (n = 7 [41%]) and in serum levels of creatine kinase (n = 7 [41%]), transaminase (n = 3 [18%]), and lactate dehydrogenase (n = 2 [12%]). The severity of illness and eosinophilia were correlated with the number of ingested snails. Meningeal and basal ganglion enhancement was noted on magnetic resonance imaging in several patients. Treatment with mebendazole combined with glucocorticosteroids appeared to shorten the course of the infection, but not the number of relapses. The eosinophil count fell to normal within 3 months, but IgE levels remained elevated for as long as 6 months. All patients recovered with minimal neurologic sequelae. Conclusion Eosinophilic meningitis caused byA. cantonensisshould be considered in patients who have headache or central nervous system manifestations after eating raw snails.
Journal title :
The American Journal of Medicine
Serial Year :
2001
Journal title :
The American Journal of Medicine
Record number :
808374
Link To Document :
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