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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
PubMed

Insights

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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