Eosinophilic meningitis caused byAngiostrongylus cantonensis: report of 17 cases

Tsai, Hung Chin; Liu, Yung Ching; Kunin, Calvin M.; Lee, Susan Shin Jung; Chen, Yao Shen; Lin, Hsi Hsun; Tsai, Tsung Hung; Lin, Wei; Huang, Chun Kai; Yen, Muh Yong; Yen, Chuan-Min

doi:10.1016/s0002-9343(01)00766-5

Cited by 144 publications

(131 citation statements)

References 16 publications

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“…Vision changes (including blurred or double vision) were more frequently reported by case-patients in our cohort than in previous studies; these symptoms could be caused by larval invasion or an inflammatory response. 13,15,16,18,32,33 Potential exposures within this cohort differ from exposures reported for point source outbreaks, particularly in Asia. With some exceptions, infected persons identified in outbreaks in Taiwan, Thailand, and elsewhere knowingly or intentionally consumed slugs or snails (e.g., during a meal or for medicinal purposes).…”

Section: Discussionmentioning

confidence: 87%

“…12,13 Following an average incubation period of 1-3 weeks, symptomatic persons often develop headache, meningeal symptoms, and sensory abnormalities. [14][15][16][17] Uncommonly, infection results in severe neuropathic and motor symptoms, coma, and death. [14][15][16][17] Most studies have reported acute symptoms; to our knowledge, few descriptions of long-term outcomes have been published.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] Uncommonly, infection results in severe neuropathic and motor symptoms, coma, and death. [14][15][16][17] Most studies have reported acute symptoms; to our knowledge, few descriptions of long-term outcomes have been published. [18][19][20] Treatment is primarily supportive; systemic corticosteroids may decrease symptom duration, but the use of antihelminthic therapy is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Hochberg

Blackburn²,

Park³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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The most common infectious cause of eosinophilic meningitis is Angiostrongylus cantonensis, which is transmitted largely by consumption of snails/slugs. We previously identified cases of angiostrongyliasis that occurred in Hawaii from 2001 to 2005; the highest incidence was on the island of Hawaii. We now report symptoms, laboratory parameters, and exposures. Eighteen patients were evaluated; 94% had headache, and 65% had sensory symptoms (paresthesia, hyperesthesia, and/or numbness). These symptoms lasted a median of 17 and 55 days, respectively. Three persons recalled finding a slug in their food/drink. Case-patients on the island of Hawaii were more likely than case-patients on other islands to consume raw homegrown produce in a typical week (89% versus 0%, P < 0.001) and to see snails/slugs on produce (56% versus 0%, P = 0.03). Residents and travelers should be aware of the potential risks of eating uncooked produce in Hawaii, especially if it is from the island of Hawaii and locally grown.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Hochberg

Blackburn²,

Park³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…Another way to enhance the sensitivity of this realtime PCR assay could be to allow the patients to sit upright for some time before performing the LP, since this has been shown to increase the likelihood of finding larvae in the sample. 32 Two patients (2011-7 and 2012-1) with positive real-time PCR results did not have specimens available for immunodiagnosis and the CO1 PCR testing was negative. This discrepancy between the two PCR-based tests is most likely because of a lower detection limit of the real-time PCR, thanks to a smaller amplicon size and more sensitive detection method (fluorescence).…”

Section: Discussionmentioning

confidence: 99%

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

Qvarnström¹,

Xayavong²,

Silva³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Angiostrongylus cantonensis is the most common infectious cause of eosinophilic meningitis. Timely diagnosis of these infections is difficult, partly because reliable laboratory diagnostic methods are unavailable. The aim of this study was to evaluate the usefulness of a real-time polymerase chain reaction (PCR) assay for the detection of A. cantonensis DNA in human cerebrospinal fluid (CSF) specimens. A total of 49 CSF specimens from 33 patients with eosinophilic meningitis were included: A. cantonensis DNA was detected in 32 CSF specimens, from 22 patients. Four patients had intermittently positive and negative real-time PCR results on subsequent samples, indicating that the level of A. cantonensis DNA present in CSF may fluctuate during the course of the illness. Immunodiagnosis and/or supplemental PCR testing supported the real-time PCR findings for 30 patients. On the basis of these observations, this real-time PCR assay can be useful to detect A. cantonensis in the CSF from patients with eosinophilic meningitis.

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“…The clinical spectrum can range from a mild disease to meningitis or encephalitis [6]. The most common clinical manifestations in a case series of 17 patients was headache (in 100% of the patients), stiff neck and fever (65%) [6].…”

Section: Discussionmentioning

confidence: 99%

An Interesting Case of Eosinophilic Meningitis

Pai

Madi

Achappa

et al. 2013

JCDR

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Angiostrongylus cantonensis is one of the causative agents of eosinophilic meningitis. Humans get infected when they ingest raw or partially cooked snails or monitor lizards (Varanus bengalensis). There is a popular belief that the tongue and the liver of the monitor lizard has aphrodisiac properties. A 20-year-old man was admitted to our hospital with a history of fever, headache and vomiting.His cerebrospinal fluid revealed eosinophilia. He gave a history of the ingestion of a monitor lizard, ten days prior to the onset of the symptoms. So, a diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis was made. He was treated with oral albendazole and prednisolone. His symptoms improved gradually within two weeks from his admission.

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Eosinophilic meningitis caused byAngiostrongylus cantonensis: report of 17 cases

Cited by 144 publications

References 16 publications

Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

An Interesting Case of Eosinophilic Meningitis

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