Eosinophilic meningitis caused by Angiostrongylus cantonensis associated with eating raw snails: Correlation of brain magnetic resonance imaging scans with clinical findings

Hung Chin Tsai, Yung Ching Liu, Calvin M. Kunin, Ping Hong Lai, Susan Shin Jung Lee, Yao Shen Chen, Shue Ren Wann, Wei Ru Lin, Chun Kai Huang, Luo Ping Ger, Hsi Hsun Lin, Muh Yong Yen

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis worldwide. Human infection occurs after ingestion of the worms in raw snails or fish that serve as intermediate hosts. Two outbreaks of central nervous system infection with A. cantonensis occurred in Kaoshiung, Taiwan, during 1998 and 1999 among Thai laborers who ate raw snails. A detailed clinical studies of 17 of these patients was conducted, including study of 13 patients who underwent magnetic resonance imaging (MRI) scans of the brain. The MRI scans revealed high signal intensities over the globus pallidus and cerebral peduncle on TI-weighted imaging, leptomeningeal enhancement, ventriculomegaly, and punctate areas of abnormal enhancement within the cerebral and cerebellar hemisphere on gadolinium-enhancing T1 imaging, and a hyperintense signal on T2-weighted images. There was a significant correlation between severity of headache, cerebrospinal fluid (CSF) pleocytosis, and CSF and blood eosinophilia with MRI signal intensity in T1-weighted imaging (P <0.05). Eosinophilic meningitis produced by A. cantonensis needs to added to the list of causes of hyperintense basal ganglia lesions found on T1-weighted MRI scans in tropical countries.

Original languageEnglish
Pages (from-to)281-285
Number of pages5
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume68
Issue number3
Publication statusPublished - Mar 2003
Externally publishedYes

Fingerprint

Angiostrongylus cantonensis
Snails
Meningitis
Eating
Magnetic Resonance Imaging
Brain
Cerebrospinal Fluid
Central Nervous System Infections
Globus Pallidus
Leukocytosis
Gadolinium
Cerebrum
Eosinophilia
Basal Ganglia
Taiwan
Disease Outbreaks
Headache
Fishes
Infection

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Eosinophilic meningitis caused by Angiostrongylus cantonensis associated with eating raw snails : Correlation of brain magnetic resonance imaging scans with clinical findings. / Tsai, Hung Chin; Liu, Yung Ching; Kunin, Calvin M.; Lai, Ping Hong; Lee, Susan Shin Jung; Chen, Yao Shen; Wann, Shue Ren; Lin, Wei Ru; Huang, Chun Kai; Ger, Luo Ping; Lin, Hsi Hsun; Yen, Muh Yong.

In: American Journal of Tropical Medicine and Hygiene, Vol. 68, No. 3, 03.2003, p. 281-285.

Research output: Contribution to journalArticle

Tsai, Hung Chin ; Liu, Yung Ching ; Kunin, Calvin M. ; Lai, Ping Hong ; Lee, Susan Shin Jung ; Chen, Yao Shen ; Wann, Shue Ren ; Lin, Wei Ru ; Huang, Chun Kai ; Ger, Luo Ping ; Lin, Hsi Hsun ; Yen, Muh Yong. / Eosinophilic meningitis caused by Angiostrongylus cantonensis associated with eating raw snails : Correlation of brain magnetic resonance imaging scans with clinical findings. In: American Journal of Tropical Medicine and Hygiene. 2003 ; Vol. 68, No. 3. pp. 281-285.
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