title: The first case of Angiostrongylus cantonensis eosinophilic meningitis diagnosed in the city of São Paulo, Brazil.
abstract: BACKGROUND
  Angiostrongylus cantonensis is a natural parasite found in lung arteries of rats, which in humans may cause eosinophilic meningitis.
  
  
  OBJECTIVE
  To report the first case of eosinophilic meningitis caused by Angiostrongylus cantonensis in the city of São Paulo, Brazil.
  
  
  METHODS
  A male patient, 11 years old, living in the southern area of São Paulo, was admitted to the Pediatric Emergency Department with ongoing headaches for three days, but no fever or any other complaint. The presence of snails and rodents was reported in the peridomicile. The child was awake, lucid, oriented; muscular strength preserved, isochoric, photo reagent pupils and terminal nuchal rigidity - Glasgow Coma Scale (GCS) = 15. The laboratory tests showed a mild leukocytosis with 1736 eosinophils/mm3 and the CSF analysis disclosed 160 leukocytes/mm3 with 36% of eosinophils. The bacterial culture was negative. Computed Cerebral Tomography showed no alterations. The RT-PCR assay for detecting Angiostrongylus cantonensis larvae and DNA was negative. ELISA antibodies for IgG anti-A. cantonensis was negative in serum and undetermined in CSF and samples collected five days after the onset of symptoms. Seroconversion was observed in the sample collected 135 days later.
  
  
  CONCLUSIONS
  the epidemiological and clinical data, the CSF alterations with eosinophilia and the seroconversion strongly suggest Angiostrongylus cantonensis eosinophilic meningitis.
authors.affiliation: Department of Infectious and Parasitic Diseases, School of Medicine at the University of São Paulo, LIM-06, São Paulo, SP, Brazil. cristinasanto@usp.br
authors.forename: Maria Cristina Carvalho do
authors.initials: MC
authors.lastname: Espírito-Santo
authors.forename: Pedro Luiz Silva
authors.initials: PL
authors.lastname: Pinto
authors.forename: Dan Jesse Gonçalves da
authors.initials: DJ
authors.lastname: Mota
authors.forename: Ronaldo César Borges
authors.initials: RC
authors.lastname: Gryschek
mesh_terms: D017185:Angiostrongylus cantonensis / Q000302:isolation & purification*; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004802:Eosinophilia / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology*