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. 1988 Jan;51(1):80–87. doi: 10.1136/jnnp.51.1.80

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

E Schmutzhard 1, P Boongird 1, A Vejjajiva 1
PMCID: PMC1032717  PMID: 3351533

Abstract

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bia F. J., Barry M. Parasitic infections of the central nervous system. Neurol Clin. 1986 Feb;4(1):171–206. [PubMed] [Google Scholar]
  2. Boongird P., Phuapradit P., Siridej N., Chirachariyavej T., Chuahirun S., Vejjajiva A. Neurological manifestations of gnathostomiasis. J Neurol Sci. 1977 Mar;31(2):279–291. doi: 10.1016/0022-510x(77)90113-7. [DOI] [PubMed] [Google Scholar]
  3. Bunnag T., Comer D. S., Punyagupta S. Eosinophilic myeloencephalitis caused by gnathostoma spinigerum. Neuropathology of nine cases. J Neurol Sci. 1970 May;10(5):419–434. doi: 10.1016/0022-510x(70)90023-7. [DOI] [PubMed] [Google Scholar]
  4. Chitanondh H., Rosen L. Fatal eosinophilic encephalomyelitis caused by the nematode Gnathostoma spinigerum. Am J Trop Med Hyg. 1967 Sep;16(5):638–645. doi: 10.4269/ajtmh.1967.16.638. [DOI] [PubMed] [Google Scholar]
  5. DAENGSVANG S., CHULALERK U., PAPASARATHORN T., TONGKOOM B. EPIDEMIOLOGICAL OBSERVATIONS ON GNATHOSTOMA SPINIGERUM IN THAILAND. J Trop Med Hyg. 1964 Jun;67:144–147. [PubMed] [Google Scholar]
  6. Daengsvang S. Chemotherapy of feline Gnathostoma spinigerum migrating stage with multiple subcutaneous doses of ancylol. Southeast Asian J Trop Med Public Health. 1980 Sep;11(3):359–362. [PubMed] [Google Scholar]
  7. Daengsvang S. Further observations on the experimental transmission of Gnathostoma spinigerum. Ann Trop Med Parasitol. 1968 Mar;62(1):88–94. doi: 10.1080/00034983.1968.11686534. [DOI] [PubMed] [Google Scholar]
  8. Dharmkrong-at A., Migasena S., Suntharasamai P., Bunnag D., Priwan R., Sirisinha S. Enzyme-linked immunosorbent assay for detection of antibody to Gnathostoma antigen in patients with intermittent cutaneous migratory swelling. J Clin Microbiol. 1986 May;23(5):847–851. doi: 10.1128/jcm.23.5.847-851.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fan K. J., Pezeshkpour G. H. Cerebral sparganosis. Neurology. 1986 Sep;36(9):1249–1251. doi: 10.1212/wnl.36.9.1249. [DOI] [PubMed] [Google Scholar]
  10. Fox A. S., Kazacos K. R., Gould N. S., Heydemann P. T., Thomas C., Boyer K. M. Fatal eosinophilic meningoencephalitis and visceral larva migrans caused by the raccoon ascarid Baylisascaris procyonis. N Engl J Med. 1985 Jun 20;312(25):1619–1623. doi: 10.1056/NEJM198506203122507. [DOI] [PubMed] [Google Scholar]
  11. Ko R. C., Chiu M. C., Kum W., Chan S. H. First report of human angiostrongyliasis in Hong Kong diagnosed by computerized axial topography (CAT) and enzyme linked immunosorbent assay. Trans R Soc Trop Med Hyg. 1984;78(3):354–355. doi: 10.1016/0035-9203(84)90119-6. [DOI] [PubMed] [Google Scholar]
  12. McCorkell S. J., Lewall D. B. Computed tomography of intracerebral echinococcal cysts in children. J Comput Assist Tomogr. 1985 May-Jun;9(3):514–518. doi: 10.1097/00004728-198505000-00020. [DOI] [PubMed] [Google Scholar]
  13. McCormick G. F., Zee C. S., Heiden J. Cysticercosis cerebri. Review of 127 cases. Arch Neurol. 1982 Sep;39(9):534–539. doi: 10.1001/archneur.1982.00510210004002. [DOI] [PubMed] [Google Scholar]
  14. Punyagupta S., Bunnag T., Juttijudata P., Rosen L. Eosinophilic meningitis in Thailand. Epidemiologic studies of 484 typical cases and the etiologic role of Angiostrongylus cantonensis. Am J Trop Med Hyg. 1970 Nov;19(6):950–958. [PubMed] [Google Scholar]
  15. Punyagupta S., Juttijudata P., Bunnag T. Eosinophilic meningitis in Thailand. Clinical studies of 484 typical cases probably caused by Angiostrongylus cantonensis. Am J Trop Med Hyg. 1975 Nov;24(6 Pt 1):921–931. [PubMed] [Google Scholar]
  16. Rosemberg S., Lopes M. B., Masuda Z., Campos R., Vieira Bressan M. C. Fatal encephalopathy due to Lagochilascaris minor infection. Am J Trop Med Hyg. 1986 May;35(3):575–578. doi: 10.4269/ajtmh.1986.35.575. [DOI] [PubMed] [Google Scholar]
  17. SMIT A. M. EOSINOPHILIC MENINGITIS. Trop Geogr Med. 1963 Sep;15:225–232. [PubMed] [Google Scholar]
  18. Scowden E. B., Schaffner W., Stone W. J. Overwhelming strongyloidiasis: an unappreciated opportunistic infection. Medicine (Baltimore) 1978 Nov;57(6):527–544. [PubMed] [Google Scholar]
  19. Scrimgeour E. M., Gajdusek D. C. Involvement of the central nervous system in Schistosoma mansoni and S. haematobium infection. A review. Brain. 1985 Dec;108(Pt 4):1023–1038. doi: 10.1093/brain/108.4.1023. [DOI] [PubMed] [Google Scholar]
  20. Vejjajiva A. Parasitic diseases of the nervous system in Thailand. Clin Exp Neurol. 1978;15:92–97. [PubMed] [Google Scholar]
  21. Woodruff A. W. Toxocariasis. Br Med J. 1970 Sep 19;3(5724):663–669. doi: 10.1136/bmj.3.5724.663. [DOI] [PMC free article] [PubMed] [Google Scholar]

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