title: Differential diagnosis of CNS angiostrongyliasis: a short review.
abstract: The diagnostic criterion for eosinophilic meningitis (EOM) is the identification of an absolute count of 10 eosinophils per ml or more than 10% of the total white blood cells in the cerebrospinal fluid (CSF) in the proper clinical context. The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA). Neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis. This short review is based on articles published on Medline between 2000 and 2012 related to EOM. There are three main approaches that can be used to differentiate between MA and NG, involving clinical factors, history of larval exposure, and serological tests. MA patients presented with acute severe headache but without neurological deficit, combined with a history of eating uncooked snails or slugs. NG patients always presented with motor weakness, migratory swelling, radicular pain and had history of eating uncooked poultry or fish. Specific antigenic bands in immunoblot tests are helpful tools to differentiate the two diseases. Other causes of eosinophilic meningitis are neurocysticercosis, cerebral paragonimiasis, Toxoplasma canis, Baylisascaris, tuberculous meningitis, and cryptococcal meningitis.
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Vichai
authors.initials: V
authors.lastname: Senthong
authors.forename: Jarin
authors.initials: J
authors.lastname: Chindaprasirt
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
mesh_terms: D017185:Angiostrongylus cantonensis / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D000818:Animals; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis* / Q000469:parasitology; D006039:Gnathostoma / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D058429:Gnathostomiasis / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D006801:Humans; D008581:Meningitis / Q000175:diagnosis* / Q000469:parasitology; D016133:Polymerase Chain Reaction; D012698:Serologic Tests; D017206:Strongylida Infections / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology
keywords: Angiostrongyliasis; Differential diagnosis; Eosinophilic meningitis; Gnathostomiasis; Rat lungworm disease
references.citation: Asian Pac J Allergy Immunol. 2001 Dec;19(4):267-73
references.pmid: 12009076
references.citation: Mem Inst Oswaldo Cruz. 2011 Aug;106(5):570-2
references.pmid: 21894378
references.citation: AJNR Am J Neuroradiol. 2004 Mar;25(3):446-9
references.pmid: 15037471
references.citation: J Helminthol. 2004 Dec;78(4):287-91
references.pmid: 15575983
references.citation: Am J Trop Med Hyg. 2010 Dec;83(6):1176-7
references.pmid: 21118917
references.citation: Lancet Infect Dis. 2008 Oct;8(10):621-30
references.pmid: 18922484
references.citation: Am J Trop Med Hyg. 2010 Oct;83(4):927-9
references.pmid: 20889894
references.citation: Clin Infect Dis. 2009 Feb 1;48(3):322-7
references.pmid: 19123863
references.citation: Clin Infect Dis. 2000 Sep;31(3):660-2
references.pmid: 11017811
references.citation: J Laryngol Otol. 2004 Jan;118(1):57-8
references.pmid: 14979976
references.citation: Pathol Res Pract. 2010 Feb 15;206(2):102-4
references.pmid: 19545957
references.citation: Parasitol Int. 2006 Mar;55(1):31-2
references.pmid: 16243581
references.citation: Southeast Asian J Trop Med Public Health. 2004 Mar;35(1):172-4
references.pmid: 15272765
references.citation: AJNR Am J Neuroradiol. 2005 Jan;26(1):39-42
references.pmid: 15661696
references.citation: Trans R Soc Trop Med Hyg. 2008 Oct;102(10):990-6
references.pmid: 18501934
references.citation: Am J Trop Med Hyg. 2006 Jun;74(6):1122-4
references.pmid: 16760531
references.citation: Parasitol Res. 2007 May;100(6):1293-6
references.pmid: 17177056
references.citation: Am J Trop Med Hyg. 2009 Oct;81(4):698-701
references.pmid: 19815890
references.citation: Neurol Sci. 2012 Aug;33(4):893-8
references.pmid: 22124854
references.citation: AJNR Am J Neuroradiol. 2000 Jun-Jul;21(6):1090-4
references.pmid: 10871020
references.citation: Trans R Soc Trop Med Hyg. 2009 Jan;103(1):102-4
references.pmid: 18951600