Eosinophilic meningitis due to Angiostrongylus Cantonensis in children

2021 ◽  
Author(s):  
Kiem Hao Tran
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Cell ◽  
Pediatric Population ◽  
Central Zone ◽  
Oral Prednisolone ◽  
Angiostrongylus Cantonensis ◽  
Eosinophilic Meningitis ◽  
Peripheral Eosinophilia ◽  
Blood Cell Count ◽  
Laboratory Results

Meningoencephalitis is not a rare disease in children. However, eosinophilic meningitis due to Angiostrongylus cantonensis is unusual in pediatric population. We describe the case of a 12-year-old girl from central zone of Vietnam with eosinophilic meningitis. The patient lived in a rural area, where farming is widespread, and presented with fever and headache. Laboratory results showed peripheral eosinophilia, cerebrospinal fluid white blood cell count 730/mm3 with many of eosinophils, cerebrospinal fluid ELISA positive for Angiostrongylus cantonensis, and blood ELISA positive for A. cantonensis. The presentation was consistent with a diagnosis of A. cantonensis eosinophilic meningitis. The patient recovered fully after administering albendazole (800mg/day for 2 weeks), and intravenous dexamethasone (0.6 mg/kg/day every 8 hours) and mannitol (1.5 g/kg/day every 8 hours) for the first 3 days, followed by 5 days of oral prednisolone (2 mg/kg/day).

scholarly journals Eosinophilic Meningitis due to Angiostrongylus cantonensis in Children

2021 ◽  
pp. 184-189
Author(s):  
Hai Thanh Phan ◽  
Kiem Hao Tran ◽  
Huu Son Nguyen
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Cell ◽  
Pediatric Population ◽  
Central Area ◽  
Oral Prednisolone ◽  
Angiostrongylus Cantonensis ◽  
Eosinophilic Meningitis ◽  
Peripheral Eosinophilia ◽  
Blood Cell Count ◽  
Laboratory Results

Meningoencephalitis is not a rare disease in children. However, eosinophilic meningitis due to Angiostrongylus cantonensis is unusual in the pediatric population. We describe the case of a 12-year-old girl from the central area of Vietnam with eosinophilic meningitis due to A. cantonensis. The patient lived in a rural area, where farming is widespread, and presented with fever and headache. Laboratory results showed peripheral eosinophilia, a cerebrospinal fluid white blood cell count of 730/mm3 with 65% eosinophils. Cerebrospinal fluid ELISA was positive for A. cantonensis, and blood ELISA was positive for A. cantonensis. The presentation was consistent with a diagnosis of A. cantonensis eosinophilic meningitis. The patient recovered fully after administration of albendazole (200 mg/day for 2 weeks), as well as intravenous dexamethasone (0.6 mg/kg/day every 8 h) and mannitol (1.5 g/kg/day every 8 h) for the first 3 days, followed by 5 days of oral prednisolone (2 mg/kg/day).

scholarly journals Cisternal versus lumbar cerebrospinal fluid lactate concentration in healthy dogs

2020 ◽  
Vol 65 (No. 7) ◽  
pp. 297-300 ◽  
Author(s):  
A Galan ◽  
A Seisdedos-Benzal ◽  
BE Carletti ◽  
S Quiros ◽  
EM Martin ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Study ◽  
Blood Cell ◽  
Cell Count ◽  
Lactate Concentration ◽  
Beagle Dogs ◽  
Blood Cell Count ◽  
Puncture Site ◽  
Protein Determination ◽  
Lumbar Cerebrospinal Fluid

The analysis of cerebrospinal fluid biomarkers provides a wide range of information about the neurological health of a patient. Lactate is a metabolic precursor necessary for brain gluconeogenesis. When oxidative impairment or mitochondrial damage is present, lactate alteration occurs. The rostro-caudal dynamics of cerebrospinal biomarkers along the craniospinal axis in humans and horses was demonstrated in other studies. To the authors’ knowledge, no clinical study has, so far, investigated the cerebrospinal fluid lactate concentration in dogs in association with the puncture site. The purpose of this study was to compare the cerebellomedullary cistern and lumbar cistern cerebrospinal fluid lactate concentrations in healthy dogs. Cerebellomedullary and lumbar cerebrospinal fluids were collected for the cell count, total protein determination and lactate analysis from ten healthy Beagle dogs. The results revealed a significantly increased lumbar cerebrospinal fluid lactate concentration when compared with the cerebellomedullary cistern level. The results included: the total nucleated cell count < 5 cells/µl, the red blood cell count < 500 cell/µl, the total proteins < 0.3 g/l, as well as the cerebellomedullary lactate values (1.44 ± 0.06 mM/l) and the lumbar cistern lactate values (1.58 ± 0.1 mM/l). The results of this study highlight useful data that help to understand the physiological lactate variations depending on the cerebrospinal fluid puncture site.

Cerebrospinal Fluid Analysis in Systemically Ill Children Without Central Nervous System Disease

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 48-51
Author(s):  
Carol Carraccio ◽  
Krystyna Blotny ◽  
Margaret C. Fisher
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Blood Cell ◽  
Neutrophil Count ◽  
Cns Infection ◽  
Blood Cell Count ◽  
Diagnostic Categories ◽  
Close Proximity ◽  
Focus Of Infection

Objective. Experience led us to question the applicability of standards for normal cerebrospinal fluid (CSF), originally developed in healthy children, to children with systemic illness but without central nervous system (CNS) infection. The purpose of this study was to test our hypothesis that systemically ill children, in the absence of CNS infection, have an elevated CSF white blood cell count and a greater percentage of neutrophils than accepted norms. Methods. We enrolled 345 patients in the following diagnostic categories: infants 1 month of age or younger with possible sepsis (n = 95), patients older than 1 month of age with possible sepsis (n = 155), patients with a focus of infection in close proximity to the CNS (n = 51), and patients presenting with seizures and fevers (n = 45). Sociodemographic data and results of CSF examination were abstracted from the medical records. Statistical analysis systems were used for data processing. Results. The CSF white blood cell count did not significantly differ from standards except for a lower mean count in the group presenting with seizures. The percent of CSF neutrophils was significantly greater than standards, however, for those patients older than 1 month of age with possible sepsis, those with a focus of infection in close proximity to the CNS, and those presenting with seizures. Data analysis by quantiles shows only 25% to 50% of patients, in each of the diagnostic categories, meeting the current definition of normal CSF neutrophil count. Conclusions. Our results show that a mean of at least 5% neutrophils may be present in the CSF with a diagnosis of fever without a source, a focus of infection in close proximity to the CNS, or a seizure with fever in the absence of CNS infection. These data support tailoring treatment based on clinical assessment rather than what is considered an abnormal CSF neutrophil count by current standards.

Curcumin alleviates eosinophilic meningitis through reduction of eosinophil count following albendazole treatment against Angiostrongylus cantonensis in mice

Parasitology ◽  
2011 ◽  
Vol 139 (3) ◽  
pp. 358-365 ◽  
Author(s):  
LING-YUH SHYU ◽  
HAN-HSIN CHANG ◽  
JENG-DONG HSU ◽  
DAVID PEI-CHENG LIN ◽  
YING-HOCK TENG ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Eosinophil Count ◽  
Combined Treatment ◽  
Angiostrongylus Cantonensis ◽  
Eosinophilic Meningitis ◽  
Curcumin Treatment ◽  
Complementary Treatment ◽  
The Dead ◽  
The Brain ◽  
Better Than

SUMMARYAngiostrongylus cantonensis (A. cantonensis) is the most common cause of parasitic eosinophilic meningitis worldwide. By using an animal model of BALB/c mice infected with A. cantonensis, previous studies indicated that the anthelmintic drug, albendazole, could kill A. cantonensis larvae and prevent further infection. However, the dead larvae will induce severe immune responses targeting at brain tissues. To alleviate the detrimental effects caused by the dead larvae, we administered curcumin, a traditional anti-inflammatory agent, as a complementary treatment in addition to albendazole therapy, to determine whether curcumin could be beneficial for treatment. The results showed that although curcumin treatment alone did not reduce worm number, combined treatment by albendazole and curcumin helped to reduce eosinophil count in the cerebrospinal fluid, better than using albendazole alone. This alleviating effect did not affect albendazole treatment alone, since histological analysis showed similar worm eradication with or without addition of curcumin. Nevertheless, curcumin treatment alone and combined albendazole-curcumin treatment did not inhibit MMP-9 expression in the brain tissue. In conclusion, curcumin, when used as a complementary treatment to albendazole, could help to alleviate eosinophilic meningitis through suppression of eosinophil count in the cerebrospinal fluid.

scholarly journals Leptospirosis meningitis transmission from a pet mouse: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Anne Christine Nordholm ◽  
Lars Haukali Omland ◽  
Steen Villumsen ◽  
Imad Al-Subeihe ◽  
Terese L. Katzenstein
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Healthy Woman ◽  
Blood Cell Count ◽  
Wide Range ◽  
Pet Rodents

Abstract Background Leptospirosis is a reemerging zoonosis with a worldwide distribution and a wide range of clinical manifestations. We report a case of leptospirosis meningitis in a previously healthy woman infected by her pet mouse. Case presentation A 27-year-old Caucasian woman with pet mice presented to our institute with a 1 week history of fever, headache, myalgia, vomiting, diarrhea, and dark urine. Her admission examination revealed neck stiffness, conjunctivitis, and icteric sclera. Her liver enzymes, bilirubin, white blood cell count, and C-reactive protein were elevated. Her cerebrospinal fluid showed an elevated white blood cell count. Polymerase chain reactions using her cerebrospinal fluid, blood, and urine showed negative results for leptospirosis, but the result of her microagglutination test was positive for Leptospira interrogans serovar sejroe with a more than threefold increase in paired sera. The patient was treated with ceftriaxone for 1 week, and her condition steadily improved. Conclusions This case report raises awareness of pet rodents as sources of leptospirosis. Leptospirosis meningitis should be considered in patients with meningeal symptoms and pet rodents.

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