Abstract

Eosinophilic meningitis may be caused by non-infectious and infectious agents. Angiostrongylus cantonensis is the commonest causative agent of eosinophilic meningitis. Rats are the primary hosts of this parasite. Humans get infected by ingestion of raw or inadequately cooked hosts (snails or monitor lizard) or food contaminated with the infective third-stage larvae. A 16-year-old boy was admitted to our hospital with history of fever, headache, and altered sensorium. Magnetic resonance imaging of the brain showed unique findings. Cerebrospinal fluid (CSF) examination showed eosinophilia and the CSF wet mount identified a larva. Patient history revealed ingestion of monitor lizard 2 weeks prior to onset of symptoms. Hence, a diagnosis of eosinophilic meningitis caused by A. cantonensis was made. He was treated with oral albendazole and steroids, resulting in gradual improvement. A. cantonensis as a cause of eosinophilic meningitis is a possibility in patients who present with headache and vomiting after eating raw meat (monitor lizard). To the best of our knowledge, this is a very rare case being reported from India where the larva was identified during the microscopic examination of the CSF.

Original languageEnglish
Pages (from-to)76
JournalJournal of Clinical Imaging Science
Volume4
DOIs
Publication statusPublished - 2014

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Angiostrongylus cantonensis
Meningitis
Lizards
Larva
Cerebrospinal Fluid
Eating
Headache
Albendazole
Snails
Eosinophilia
Meat
Vomiting
India
Parasites
Fever
Steroids
Magnetic Resonance Imaging
Food
Brain

Cite this

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title = "Unusual Larva in the CSF and Unique MRI Findings in a Case of Eosinophilic Meningitis",
abstract = "Eosinophilic meningitis may be caused by non-infectious and infectious agents. Angiostrongylus cantonensis is the commonest causative agent of eosinophilic meningitis. Rats are the primary hosts of this parasite. Humans get infected by ingestion of raw or inadequately cooked hosts (snails or monitor lizard) or food contaminated with the infective third-stage larvae. A 16-year-old boy was admitted to our hospital with history of fever, headache, and altered sensorium. Magnetic resonance imaging of the brain showed unique findings. Cerebrospinal fluid (CSF) examination showed eosinophilia and the CSF wet mount identified a larva. Patient history revealed ingestion of monitor lizard 2 weeks prior to onset of symptoms. Hence, a diagnosis of eosinophilic meningitis caused by A. cantonensis was made. He was treated with oral albendazole and steroids, resulting in gradual improvement. A. cantonensis as a cause of eosinophilic meningitis is a possibility in patients who present with headache and vomiting after eating raw meat (monitor lizard). To the best of our knowledge, this is a very rare case being reported from India where the larva was identified during the microscopic examination of the CSF.",
author = "Santosh Rai and Deepak Madi and Shivanand Pai and Shrikala Baliga",
year = "2014",
doi = "10.4103/2156-7514.148303",
language = "English",
volume = "4",
pages = "76",
journal = "Journal of Clinical Imaging Science",
issn = "2156-7514",
publisher = "Medknow Publications and Media Pvt. Ltd",

}

TY - JOUR

T1 - Unusual Larva in the CSF and Unique MRI Findings in a Case of Eosinophilic Meningitis

AU - Rai, Santosh

AU - Madi, Deepak

AU - Pai, Shivanand

AU - Baliga, Shrikala

PY - 2014

Y1 - 2014

N2 - Eosinophilic meningitis may be caused by non-infectious and infectious agents. Angiostrongylus cantonensis is the commonest causative agent of eosinophilic meningitis. Rats are the primary hosts of this parasite. Humans get infected by ingestion of raw or inadequately cooked hosts (snails or monitor lizard) or food contaminated with the infective third-stage larvae. A 16-year-old boy was admitted to our hospital with history of fever, headache, and altered sensorium. Magnetic resonance imaging of the brain showed unique findings. Cerebrospinal fluid (CSF) examination showed eosinophilia and the CSF wet mount identified a larva. Patient history revealed ingestion of monitor lizard 2 weeks prior to onset of symptoms. Hence, a diagnosis of eosinophilic meningitis caused by A. cantonensis was made. He was treated with oral albendazole and steroids, resulting in gradual improvement. A. cantonensis as a cause of eosinophilic meningitis is a possibility in patients who present with headache and vomiting after eating raw meat (monitor lizard). To the best of our knowledge, this is a very rare case being reported from India where the larva was identified during the microscopic examination of the CSF.

AB - Eosinophilic meningitis may be caused by non-infectious and infectious agents. Angiostrongylus cantonensis is the commonest causative agent of eosinophilic meningitis. Rats are the primary hosts of this parasite. Humans get infected by ingestion of raw or inadequately cooked hosts (snails or monitor lizard) or food contaminated with the infective third-stage larvae. A 16-year-old boy was admitted to our hospital with history of fever, headache, and altered sensorium. Magnetic resonance imaging of the brain showed unique findings. Cerebrospinal fluid (CSF) examination showed eosinophilia and the CSF wet mount identified a larva. Patient history revealed ingestion of monitor lizard 2 weeks prior to onset of symptoms. Hence, a diagnosis of eosinophilic meningitis caused by A. cantonensis was made. He was treated with oral albendazole and steroids, resulting in gradual improvement. A. cantonensis as a cause of eosinophilic meningitis is a possibility in patients who present with headache and vomiting after eating raw meat (monitor lizard). To the best of our knowledge, this is a very rare case being reported from India where the larva was identified during the microscopic examination of the CSF.

U2 - 10.4103/2156-7514.148303

DO - 10.4103/2156-7514.148303

M3 - Article

C2 - 25806134

VL - 4

SP - 76

JO - Journal of Clinical Imaging Science

JF - Journal of Clinical Imaging Science

SN - 2156-7514

ER -