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Eosinophilic meningitis: what's the "diff"?
Michael A Miller1, Michael Menowsky2, Kimberly Leeson2
1Department of Emergency Medicine, Christus Spohn Memorial Hospital, Texas A&M-Christus Spohn Emergency Medicine Residency, Corpus Christi TX, USA; Department of Emergency Medicine, Tripler Army Medical Center, Honolulu, Hawaii.
The American Journal of Emergency Medicine
|September 25, 2013
Summary
A young man developed eosinophilic meningitis from Angiostrongylus cantonensis (AC) after snail exposure in the US. This case highlights the importance of considering AC in patients with neurological symptoms and a relevant exposure history.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Angiostrongylus cantonensis (AC), also known as the rat lungworm, is a nematode parasite that can cause eosinophilic meningitis in humans.
- AC is endemic in Southeast Asia and the Pacific Islands, but recent cases have been reported in other regions, including the United States.
Observation:
- A 22-year-old man presented to the emergency department with altered mental status.
- He had a history of exposure to snails, a known intermediate host for AC.
Findings:
- The patient was diagnosed with eosinophilic meningitis due to Angiostrongylus cantonensis.
- This represents a case of AC infection acquired within the United States.
Implications:
- This case underscores the expanding geographic range of Angiostrongylus cantonensis and the potential for human infections in non-endemic areas.
- Clinicians should maintain a high index of suspicion for AC in patients presenting with eosinophilic meningitis, especially with a history of potential exposure to infected snails or slugs.
- Public health awareness and surveillance are crucial for monitoring and preventing the spread of Angiostrongylus cantonensis.
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