Department of parasitology, faculty of medicine siriraj hospital, mahidol university, bangkok 10700, thailand. Noninfectious agents, fungi, bacteria, rickettsieae, viruses and multiple parasites have all been linked to eosinophilic meningitis. The clinical presentation includes a spectrum of disease, from meningitis through radiculitis, cranial nerve abnormalities, ataxia, encephalitis, coma, and rarely death. Case report a case report on eosinophilic meningitis caused by angiostrongylus cantonensis jingyao liu, jiguo gao, chunkui zhou department of neurology, jilin university first hospital, changchun 031, china. A case report on eosinophilic meningitis caused by. Kunin, susan shinjung lee, yaoshen chen, hsihsun lin, tsunghung tsai, weiru lin, chunkai huang, muhyong yen. Patients given a 2week course of prednisolone treatment group, 60 mgday, were compared with those given placebo control group in a randomized, doubleblind trial. However, in 2002 an outbreak of eosinophilic meningitis was reported in the us. Eosinophilic meningitis is defined as the presence of more than 10 eosinophilsmm3in the cerebrospinal fluid csf andor eosinophils accounting for more than 1 it seems to us that you have your javascript disabled on your browser. Outbreak of eosinophilic meningitis associated with drinking. Meningitis is an inflammation of the meninges, a protective covering of the brain and spinal cord, and nematodes can induce such inflammation. Department of medicine faculty of medicine khon kaen university.
Eosinophilic meningitis is the hallmark of the disease and is defined as the presence of 10 or more eosinophils per l of csf andor eosinophils. Angiostrongylus eosinophilic meningitis is caused by human infection with larvae of the rat lungworm, angiostrongylus cantonensis. Corticosteroid treatment of eosinophilic meningitis. Worldwide, infection with the helminthic parasite, angiostrongylus cantonensis, is the most common infectious etiology. Instead, another cell type called eosinophils are found this is called eosinophilic meningitis, though these cells may be absent early and late in the course of disease. Eosinophilic meningitis has been described with the idiopathic hypereosinophilic syndrome, but it is not one of the more common manifestations of this disorder. These wormspecific infections are named after the causative. This pdf is available for free download from a site hosted by medknow publications. Eosinophilic meningitis due to angiostrongylus and. Eosinophilic meningitis em is a distinct clinical entity that may have infectious and noninfectious causes. Rat lungworm angiostrongylus cantonensis in hawaii. Background outbreaks of eosinophilic meningitis caused by the roundworm angiostrongylus cantonensis are rarely reported, even in regions of endemic infection such as southeast asia and the pacific. Eosinophilic meningitis is defined as a csf eosinophil count above 10% of the total cell count, or exceeding 10 eosinophilsl.
Making a definitive diagnosis of eosinophilic meningitis due to a. Eosinophilic meningitis caused by angiostrongylus cantonensis a neglected disease with escalating importance eamsobhana, p. The current status of laboratory diagnosis of angiostrongylus. An early diagnostic test was an intradermal test based on a skin reaction to adult a. Among the infectious agents, angiostrongylus cantonensis and gnathostoma spinigerum are the most common. Biology, distribution, epidemiology, detection, diagnosis, treatment, and management. Report of 17 cases hungchin tsai, yungching liu, calvin m. Eosinophilic meningitis due to angiostrongylus cantonensis in. Affairs directorate general for development cooperation.
Information on eosinophilic meningitis how can i protect. Rat lungworm angiostrongylus cantonensis chen, 1935. Key diagnostic considerations when evaluating a patient presenting with chronic inflam. This study sought to determine the key molecules and its underlying mechanism in inducing brain eosinophilic. This study sought to determine the key molecules and its underlying mechanism in inducing brain eosinophilic infiltration caused by angiostrongylus. Manual reevaluation of the csf smear revealed 44% eosinophils with no neutrophils. Eosinophilic meningitis is the hallmark of the disease and is defined as the presence of 10 or more eosinophils per l of csf andor eosinophils accounting for more than 10% of csf white blood cells when there are at least 6 total wbc per l in csf. Current management of eosinophilic meningitis somsak tiamkao, m. High sensitivity 91% and specificity 98% for detecting serum antibodies in patients with eosinophilic meningitis or meningoencephalitis have been obtained by an elisa incorporating a purified acl. Eosinophilic meningitis caused by angiostrongylus cantonensis, the rat lungworm. Case series of eosinophilic meningoencephalitis from south. Case series of eosinophilic meningoencephalitis from south india.
Department of parasitology, faculty of medicine siriraj hospital, mahidol university, bangkok 10700, thailand corresponding author email. Some of the infectious agents that cause eosinophilic meningitis are parasites that are endemic outside of north america and europe but. Autochthonous case of eosinophilic meningitis caused by. Meningitis with a high percentage of eosinophils a type of white blood cell in the cerebrospinal fluid csf. Eosinophilic meningitistoxocariasisparasitic zoonosis. This is a pdf file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and.
Angiostrongyliasis, the most common infectious cause of eosinophilic meningitis, results from infection by the parasitic nematode angiostrongylus cantonensis 1. In a series of 217 samples from patients with meningitis, csf eosinophilia was reported in 2. Angiostrongylus cantonensis, an important foodborne parasite, can induce serious eosinophilic meningitis in nonpermissive hosts, such as mouse and human. Eosinophilic meningitis eom is an acute disease that affects the central nervous system. Angiostrongylus cantonensis eosinophilic meningitis in a returned. Some of the infectious agents that cause eosinophilic meningitis are parasites that are endemic outside of north america and europe but have a global distribution due to travel. Eosinophilic meningitis although eosinophilic meningitis is not a mandatory reportable disease, reporting is recommended to aid in the understanding of its epidemiology and disease burden. Primary amebic meningoencephalitis pam is a very rare form of parasitic meningitis that causes a fatal brain infection. Eosinophilic meningitis is a rare clinical entity that can be useful in narrowing the differential diagnosis of central nervous system disease. Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Pdf eosinophilic meningoencephalitis is caused by a variety of helminthic infections. People become infected with this parasite by ingesting its larvae in. It is primarily caused by infection with the nematode angiostrongylus cantonensis.
Eosinophilic meningitis can be the result of noninfectious causes and infectious agents. Background outbreaks of eosinophilic meningitis caused by the roundworm angiostrongylus cantonensis are rarely reported, even in regions of endemic infection such as. Eosinophilic meningitis caused by primary angiitis of the. L in the cerebrospinal fluid csf or a csf eosinophilia of at least 10%. Begue infection by baylisascaris procyonis is an uncommon but devastating cause of eosinophilic meningitis. Cerebrospinal fluid eosinophilia in dogs windsor 2009. Eosinophils are a type of diseasefighting white blood cells, and their concentration in the blood increases when foreign organisms such as parasites are present.
After symptomatic analgetic treatment flupirtine 1. Information on eosinophilic meningitis what is eosinophilic meningitis. Eosinophilic meningitis definition of eosinophilic. The usual cause is the parasite angiostrongylus cantonensis, also known as the rat lungworm. The most common cause of eosinophilic meningitis is the rat lungworm angiostrongylus cantonensis, a parasite that is endemic in the southeast asian and pacific regions. An eosinophilic reaction develops in response to the dying larvae. Eosinophilic meningitis due to angiostrongylus and gnathostoma. To ascertain presence of this parasite in patients in laos with eosinophilic meningitis, we performed quantitative pcrs on 36 cerebrospinal fluid samples. Preliminary guidelines for the diagnosis and treatment of. Angiostrongyliasis is usually a clinical diagnosis. Eosinophilic meningitis is defined by the presence of at least 10% eosinophils in the total cerebrospinal fluid csf leukocyte count. Eosinophilic meningitis caused by angiostrongylus cantonensis. Eosinophilic meningitis is a special form of meningitis diagnosed by the examination of the spinal fluid taken from a spinal tap. Full recovery from baylisascaris procyonis eosinophilic.
How do i become infected with eosinophilic meningitis. Marked eosinophilic meningitis or meningoencephalomyelitis eme is rarely reported in dogs and the cause is usually undetermined. The main etiologies of eosinophilic meningitis are parasitic infectious diseases among which a. A 76yearold man who developed cognitive dysfunction and consciousness disturbance had eosinophilic meningitis his csf contained 19. Angiostrongylus is a parasitic nematode that can cause severe gastrointestinal or central nervous system disease in humans, depending on the species. Dec 28, 2015 instead, another cell type called eosinophils are found this is called eosinophilic meningitis, though these cells may be absent early and late in the course of disease. Retrospectively, he recalled consumption of raw liver of monitor lizard one week prior to the onset of symptoms. Longterm prognosis for dogs with cerebrospinal fluid csf eosinophilia is variable. Treatment usually requires the concomitant administration of corticoids and anthelminthic.
We started empiric treatment with levamisole 14 mg bid, 2. The role of corticosteroids in the treatment of eosinophilic meningitis has not been definitely established. Angiostrongylus cantonensis eosinophilic meningitis in a returned traveler. A case of eosinophilic meningitis article pdf available in sri lanka journal of child health 491. Historically, this infection has been acquired through ingestion of competent intermediate and paratenic carrier hosts or contaminated food in southeast. After the treatment, the patients headache was relieved and body temperature was normal. Nov 01, 2001 eosinophilic meningitis has been described with the idiopathic hypereosinophilic syndrome, but it is not one of the more common manifestations of this disorder.
Get a printable copy pdf file of the complete article 433k, or click on a page image below to browse page by page. An external file that holds a picture, illustration, etc. Introduction eosinophilic meningitis is defined asthe presence of more than 10 eosinophilsmm3 in the cerebrospinal fluid csf eosinophils accounting for more than 10 percent of csf leukocytes 2. Helminthic infections are the most common cause of eosinophilic meningoencephalitis. Full recovery from baylisascaris procyonis eosinophilic meningitis poulomi j. Review of idiopathic eosinophilic meningitis in dogs and cats.
Twothirds received albendazole or mebendazole treatment, although this is not currently recommended. The clinical presentation includes a spectrum of disease, from meningitis through radiculitis, cranial nerve abnormalities, ataxia, encephalitis, coma, and. Eosinophilic meningitis is defined as the presence of 10 eosinophilsmm3 in the cerebrospinal fluid csf or eosinophils accounting for more than 10% of csf leukocytes. Pdf update on eosinophilic meningoencephalitis and its clinical. The diagnosis of eosinophilic meningoencephalitis is based on clinical manifestations and. Get a printable copy pdf file of the complete article 838k, or click on a page image below to browse page by page.
It is defined by the presence of 10 or more eosinophils. Eosinophilic meningitis due to angiostrongylus cantonensis in europe. Outbreaks of eosinophilic meningitis associated with drinking raw vegetable juice are rarely reported, even in regions of endemic infection. Pdf normal cerebrospinal fluid csf does not contain eosinophils.
Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. We describe a case of eosinophilic meningitis caused by a. The parasite enters the body through the nose and is caused by the microscopic ameba a singlecelled living organism naegleria fowleri. However, the characteristics and mechanisms of the infection are still poorly understood. This infection was previously restricted to certain asian countries and the pacific islands, but it was first reported in brazil in 2007. Eosinophilic meningitis may occur as a complication of many. This article describes the background, clinical presentation, diagnosis, and treatment of selected etiologies of subacute and chronic meningitis. Therefore, we diagnosed eosinophilic meningitis, but at this point, the etiology was uncertain.
Links to pubmed are also available for selected references. Angiostrongylus cantonensis, which is also known as the rat lungworm, causes eosinophilic meningitis and is prevalent in southeast asia and tropical pacific islands. The clinical presentation includes a spectrum of disease, from. Review of idiopathic eosinophilic meningitis in dogs and cats, with a detailed description of two recent cases in dogs. Case report a case report on eosinophilic meningitis caused. Historically, this infection has been acquired through ingestion of competent intermediate and paratenic carrier hosts or contaminated food in southeast asia and. The most common symptoms are fever, headache, and neck stiffness. It is manifested by an outpouring of eosinophils in the csf.
Eosinophilic meningitis caused by angiostrongylus cantonensi. Eosinophilic meningitis article about eosinophilic. As a result, regional epidemiology and burden are poorly characterized. These numbers most probably were arbitrarily chosen from studies of csf cellularity in healthy individuals as cited by kuberski and have been accepted as the criteria for eosinophilic meningitis 230, 237, 295. Update on eosinophilic meningoencephalitis and its clinical. Full text full text is available as a scanned copy of the original print version. Introduction eosinophilic meningitis is defined asthe presence of more than 10 eosinophilsmm3 in the cerebrospinal fluid csf eosinophils accounting for more than 10. Overall, 22% 24109 of rats harbored adult worms, and 8% 448 of snails harbored a. Dec 21, 2018 an eosinophilic reaction develops in response to the dying larvae.
985 1179 216 924 463 869 1048 1439 668 943 280 314 498 1206 959 52 389 645 552 1 1351 765 1475 773 678 1384 891 1093 1401 1218 295 743 1396 424 688 1106 106 139 145 409