Eosinophilic meningitis and radiculomyelitis in Thailand, caused by CNS invasion of Gnathostoma spinigerum and Angiostrongylus cantonensis

During the 6 year period from January 1980 to December 1985 44 patients with infection of the central nervous system by Gnathostoma spinigerum or Angiostrongylus cantonensis were admitted to the Division of Neurology, Ramathibodi Hospital, Bangkok, Thailand. In 16 patients the diagnosis could be con...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1988-01, Vol.51 (1), p.80-87
Main Authors: Schmutzhard, E, Boongird, P, Vejjajiva, A
Format: Article
Language:English
Subjects:
Adult
Aged
Angiostrongylus - pathogenicity
Animals
Biological and medical sciences
Diagnosis, Differential
Diseases caused by nematodes
Eosinophilia - parasitology
Female
Gnathostoma - pathogenicity
Helminthic diseases
Humans
Hydrocephalus - parasitology
Infectious diseases
Larva migrans syndromes
Male
Medical sciences
Meningitis - parasitology
Middle Aged
Myelitis - parasitology
Nematode Infections - parasitology
Nervous system involvement in other diseases. Miscellaneous
Neurology
Parasitic diseases
Radiculopathy - parasitology
Risk Factors
Subarachnoid Hemorrhage - parasitology
Thailand
Tropical medicine
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Summary:During the 6 year period from January 1980 to December 1985 44 patients with infection of the central nervous system by Gnathostoma spinigerum or Angiostrongylus cantonensis were admitted to the Division of Neurology, Ramathibodi Hospital, Bangkok, Thailand. In 16 patients the diagnosis could be confirmed serologically by means of ELISA techniques. In gnathostomiasis encephalitis, myelitis, radiculitis and subarachnoid haemorrhage formed the majority of clinical syndromes. Intracerebral haematoma and transitory obstructive hydrocephalus are described in this report as being caused by Gnathostoma spinigerum infection for the first time. In angiostronglyus infections the clinical syndrome of meningitis was predominant, but one patient, whose angiostrongyliasis was proved serologically, also showed bilateral paresis of abducens nerve. The main laboratory finding was eosinophilic pleocytosis in the CSF (greater than 10%) which in patients originating or returning from South-East-Asia, particularly Thailand, is highly suggestive of these parasitic infections. Increasing transcontinental travel, influx of refugees and those seeking asylum as well as importation of food from South East Asian countries demand greater awareness of these parasitic infections even in Central Europe.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.51.1.80