Angiostrongylosis meningomyelitis without blood eosinophilia

Angiostrongylus cantonensis and Gnathostoma spinigerum usually cause eosinophilic meningitis with associated peripheral blood eosinophilia. A 44-year-old man developed acute paraplegia with bowel and bladder dysfunction. Spinal magnetic resonance images showed a long T2W hyperintensity signal from...

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Main Authors: Thanyalak Amornpojnimman, Nuttha Sanghan, Nichanan Ekpitakdamrong, Prut Koonalinthip, Sumonthip Leelawai, Pornchai Sathirapanya
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2021-12-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/14975
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author Thanyalak Amornpojnimman
Nuttha Sanghan
Nichanan Ekpitakdamrong
Prut Koonalinthip
Sumonthip Leelawai
Pornchai Sathirapanya
author_facet Thanyalak Amornpojnimman
Nuttha Sanghan
Nichanan Ekpitakdamrong
Prut Koonalinthip
Sumonthip Leelawai
Pornchai Sathirapanya
author_sort Thanyalak Amornpojnimman
collection DOAJ
description Angiostrongylus cantonensis and Gnathostoma spinigerum usually cause eosinophilic meningitis with associated peripheral blood eosinophilia. A 44-year-old man developed acute paraplegia with bowel and bladder dysfunction. Spinal magnetic resonance images showed a long T2W hyperintensity signal from the 1st to 8th spinal thoracic level. Cerebrospinal fluid analysis revealed eosinophilia and elevated cerebrospinal fluid protein, whereas differential leucocytes count in peripheral blood was unremarkable. Positive immunoblot tests for A. cantonensis antibody in serum and cerebrospinal fluid were reported. The patient had neither history of recent traveling to the high endemic areas of the parasite in Thailand, nor consumption the parasitic hosts. Immediate treatment with intravenous pulse methylprednisolone and oral albendazole resulted in complete recovery. Despite an unremarkable differential leucocytes count, absence a history of parasitic hosts consumption, and a less common presentation with meningomyelitis, A. cantonensis should be considered when cerebrospinal fluid eosinophilia presents.
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institution OA Journals
issn 1972-2680
language English
publishDate 2021-12-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-4b998f635f9f4ec0a07c85bcd65bcd102025-08-20T02:14:07ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-12-01151210.3855/jidc.14975Angiostrongylosis meningomyelitis without blood eosinophiliaThanyalak Amornpojnimman0Nuttha Sanghan1Nichanan Ekpitakdamrong2Prut Koonalinthip3Sumonthip Leelawai4Pornchai Sathirapanya5Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandDepartment of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandDivision of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandDivision of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandDivision of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandDivision of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand Angiostrongylus cantonensis and Gnathostoma spinigerum usually cause eosinophilic meningitis with associated peripheral blood eosinophilia. A 44-year-old man developed acute paraplegia with bowel and bladder dysfunction. Spinal magnetic resonance images showed a long T2W hyperintensity signal from the 1st to 8th spinal thoracic level. Cerebrospinal fluid analysis revealed eosinophilia and elevated cerebrospinal fluid protein, whereas differential leucocytes count in peripheral blood was unremarkable. Positive immunoblot tests for A. cantonensis antibody in serum and cerebrospinal fluid were reported. The patient had neither history of recent traveling to the high endemic areas of the parasite in Thailand, nor consumption the parasitic hosts. Immediate treatment with intravenous pulse methylprednisolone and oral albendazole resulted in complete recovery. Despite an unremarkable differential leucocytes count, absence a history of parasitic hosts consumption, and a less common presentation with meningomyelitis, A. cantonensis should be considered when cerebrospinal fluid eosinophilia presents. https://jidc.org/index.php/journal/article/view/14975myelitiscerebrospinal fluidAngiostrongyliasis
spellingShingle Thanyalak Amornpojnimman
Nuttha Sanghan
Nichanan Ekpitakdamrong
Prut Koonalinthip
Sumonthip Leelawai
Pornchai Sathirapanya
Angiostrongylosis meningomyelitis without blood eosinophilia
Journal of Infection in Developing Countries
myelitis
cerebrospinal fluid
Angiostrongyliasis
title Angiostrongylosis meningomyelitis without blood eosinophilia
title_full Angiostrongylosis meningomyelitis without blood eosinophilia
title_fullStr Angiostrongylosis meningomyelitis without blood eosinophilia
title_full_unstemmed Angiostrongylosis meningomyelitis without blood eosinophilia
title_short Angiostrongylosis meningomyelitis without blood eosinophilia
title_sort angiostrongylosis meningomyelitis without blood eosinophilia
topic myelitis
cerebrospinal fluid
Angiostrongyliasis
url https://jidc.org/index.php/journal/article/view/14975
work_keys_str_mv AT thanyalakamornpojnimman angiostrongylosismeningomyelitiswithoutbloodeosinophilia
AT nutthasanghan angiostrongylosismeningomyelitiswithoutbloodeosinophilia
AT nichananekpitakdamrong angiostrongylosismeningomyelitiswithoutbloodeosinophilia
AT prutkoonalinthip angiostrongylosismeningomyelitiswithoutbloodeosinophilia
AT sumonthipleelawai angiostrongylosismeningomyelitiswithoutbloodeosinophilia
AT pornchaisathirapanya angiostrongylosismeningomyelitiswithoutbloodeosinophilia