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Volume 15, Number 6—June 2009


Meningitis and Radiculomyelitis Caused by Angiostrongylus cantonensis

Tomislav MaretićComments to Author , Marta Perović, Adriana Vince, Davorka Lukas, Paron Dekumyoy, and Josip Begovac
Author affiliations: University Hospital for Infectious Diseases Dr Fran Mihaljevic, Zagreb, Croatia (T. Maretić, M. Perović, A. Vince, D. Lukas, J. Begovac); Mahidol University, Bangkok, Thailand (P. Dekumyoy)

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Epidemiologic and clinical findings from 11 reported case-patients with Angiostrongylus cantonensis infection, Europe*

Country, year of report Patient age, y/ sex Possible country of origin Suspected food Clinical features Diagnosis Treatment Ref.
France, 1988 1/F Tahiti Not reported Eosinophillic meningoencephalitis, lumbosacral myeloradiculitis, tetraplegia coma, hypertensive hydrocephalus, paresthesias IFA Thiabendazole, steroids, ventriculoperitoneal catheter (1)
Switzerland, 1995 46/F Tahiti Freshwater shrimp Eosinophilic meningoradiculits Clinical Supportive (2)
France, 1996 25/F Tahiti Raw fish Eosinophilic meningitis, paresthesias (left lower leg) Clinical Supportive (3)
France, 2002 16/M Tahiti Not reported Eosinophilic meningoencephalitis, cranial palsy (n. abducens), cerebellar syndrome, paresthesias IFA Ivermectin (4)
Switzerland, 2004 26/M Cuba Not reported Eosinophilic meningitis, generalized hyperesthesias WB Supportive (5)
Germany, 2006 27/F Dominican Republic Not reported Eosinophilic meningitis, paresthesias (right elbow, right thigh) WB Albendazole, steroids (6)
Italy, 2007 30/M Dominican Republic Freshwater shrimp Eosinophilic meningitis, generalized paresthesias Clinical Mebendazole,† steroids (7)
UK, 2007 30/F Thailand Snails Eosinophilic meningitis, cranial nerve palsy (right n. abducens), altered sensation (lateral border of right leg) Serologic‡ Supportive (8)
Belgium, 2008 22/F Costa Rica, Ecuador, Chile, Argentina, Fiji Islands Sashimi, ceviche (raw fish), salads Eosinophilic meningitis, paresthesias (left hemithorax, feet) WB Albendazole, steroids (9)
France, 2008§ 26–36/M French Polynesia Uncooked
freshwater prawns Eosinophilic meningitis¶ Clinical Ivermectin (1 patient) or albendazole; steroids (1 patient) (10)
Croatia 47/M Malaysia, Singapore Vegetables, salads,
shrimp# Eosinophilic meningitis, lumbosacral myeloradiculitis (conus medullaris syndrome), generalized paresthesias WB Supportive (repeated lumbar puncture) This study

*Ref., reference; IFA, immunofluorescent antibody assay; WB, Western blot.
†One dose only.
‡Method not specified.
§Five French policemen.
¶Diagnosis confirmed by cerebrospinal fluid analysis in only 1 patient.
#The patient thought he consumed saltwater shrimp but was uncertain.

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