Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment

Angiostrongylus cantonensis (AC) is a parasite that occasionally infects humans, causing eosinophilic meningitis (EM). In this study, we identified two adult males with severe angiostrongyliasis being treated at the ICU. Both presented with mental and behavioral abnormalities and were initially trea...

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Main Authors: Xiaomiao Tang, Juanjuan Wu, Yefeng Yang, Yingqiong Wang, Chengji Jin, Chengzhi Xie, Mei Wang, Run Liu, Xiaozhi Wang, Fengyun Wang, Jing Wang
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S187603412500108X
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author Xiaomiao Tang
Juanjuan Wu
Yefeng Yang
Yingqiong Wang
Chengji Jin
Chengzhi Xie
Mei Wang
Run Liu
Xiaozhi Wang
Fengyun Wang
Jing Wang
author_facet Xiaomiao Tang
Juanjuan Wu
Yefeng Yang
Yingqiong Wang
Chengji Jin
Chengzhi Xie
Mei Wang
Run Liu
Xiaozhi Wang
Fengyun Wang
Jing Wang
author_sort Xiaomiao Tang
collection DOAJ
description Angiostrongylus cantonensis (AC) is a parasite that occasionally infects humans, causing eosinophilic meningitis (EM). In this study, we identified two adult males with severe angiostrongyliasis being treated at the ICU. Both presented with mental and behavioral abnormalities and were initially treated for psychiatric disorders before showing symptoms like cough, fever, and altered consciousness. Patient 1, a homeless individual, presented with elevated eosinophil levels and typical meningitis symptoms, prompting an early diagnosis of EM that was later confirmed via next-generation sequencing (NGS) of the cerebrospinal fluid. Patient 2, who had schizophrenia as a pre-existing condition, did not exhibit the typical signs of meningitis but was nonetheless detected via NGS. Both patients responded well to corticosteroids and anthelmintics. A review of case reports underscores heightened infection risks among children with pica and vulnerable adults, including those with mental disorders or homelessness. The use of NGS is effective for the early diagnosis and treatment of severe angiostrongyliasis, especially in those with atypical symptoms.
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institution DOAJ
issn 1876-0341
language English
publishDate 2025-05-01
publisher Elsevier
record_format Article
series Journal of Infection and Public Health
spelling doaj-art-3f3eb67754504085b98ef818e9ffa02d2025-08-20T03:08:24ZengElsevierJournal of Infection and Public Health1876-03412025-05-0118510275910.1016/j.jiph.2025.102759Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatmentXiaomiao Tang0Juanjuan Wu1Yefeng Yang2Yingqiong Wang3Chengji Jin4Chengzhi Xie5Mei Wang6Run Liu7Xiaozhi Wang8Fengyun Wang9Jing Wang10Department of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China; Correspondence to: No.368, Yihai Avenue, Longhua District, Haikou, Hainan Province, China.Department of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China; NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China; Correspondence to: No.368, Yihai Avenue, Longhua District, Haikou, Hainan Province, China.Angiostrongylus cantonensis (AC) is a parasite that occasionally infects humans, causing eosinophilic meningitis (EM). In this study, we identified two adult males with severe angiostrongyliasis being treated at the ICU. Both presented with mental and behavioral abnormalities and were initially treated for psychiatric disorders before showing symptoms like cough, fever, and altered consciousness. Patient 1, a homeless individual, presented with elevated eosinophil levels and typical meningitis symptoms, prompting an early diagnosis of EM that was later confirmed via next-generation sequencing (NGS) of the cerebrospinal fluid. Patient 2, who had schizophrenia as a pre-existing condition, did not exhibit the typical signs of meningitis but was nonetheless detected via NGS. Both patients responded well to corticosteroids and anthelmintics. A review of case reports underscores heightened infection risks among children with pica and vulnerable adults, including those with mental disorders or homelessness. The use of NGS is effective for the early diagnosis and treatment of severe angiostrongyliasis, especially in those with atypical symptoms.http://www.sciencedirect.com/science/article/pii/S187603412500108XAngiostrongyliasisEosinophilic meningitisEarly diagnosisNext-generation sequencingVulnerable groups
spellingShingle Xiaomiao Tang
Juanjuan Wu
Yefeng Yang
Yingqiong Wang
Chengji Jin
Chengzhi Xie
Mei Wang
Run Liu
Xiaozhi Wang
Fengyun Wang
Jing Wang
Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
Journal of Infection and Public Health
Angiostrongyliasis
Eosinophilic meningitis
Early diagnosis
Next-generation sequencing
Vulnerable groups
title Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
title_full Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
title_fullStr Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
title_full_unstemmed Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
title_short Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment
title_sort severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults early diagnosis via next generation sequencing and successful treatment
topic Angiostrongyliasis
Eosinophilic meningitis
Early diagnosis
Next-generation sequencing
Vulnerable groups
url http://www.sciencedirect.com/science/article/pii/S187603412500108X
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