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Am. J. Trop. Med. Hyg., 81(4), 2009, pp. 698-701
doi:10.4269/ajtmh.2009.09-0309;
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Clinical Factors Predictive of Encephalitis Caused by Angiostrongylus cantonensis

Kittisak Sawanyawisuth*, Ken Takahashi, Tsutomu Hoshuyama, Kanlayanee Sawanyawisuth, Vichai Senthong, Panita Limpawattana, Pewpan M. Intapan, Donald Wilson, Somsak Tiamkao, Suthipun Jitpimolmard, AND Verajit Chotmongkol
Departments of Medicine, Biochemistry, and Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu City, Japan

Angiostrongylus cantonensis is mainly caused eosinophilic meningitis in humans, whereas a minority of patients develop encephalitic angiostrongyliasis (EA). EA is an extremely fatal condition, and the clinical factors predictive of EA have never been reported. A comparison study was conducted in a hospital situated in an endemic area of Thailand. We enrolled 14 and 80 angiostrongyliasis patients who developed encephalitis and meningitis, respectively. Logistic regression analysis was used to assess the clinical variables predictive of encephalitis. Age (adjusted odds ratio [OR], 1.22; 95% confidence interval [CI], 1.05–1.42), duration of headache (adjusted OR, 1.26; 95% CI, 1.03–1.55), and fever > 38.0°C (adjusted OR, 37.05; 95% CI, 1.59–862.35) were identified as statistically significant factors for EA prediction. Elderly patients with angiostrongyliasis experiencing fever and prolonged headaches were at the highest risk of developing EA.

Received June 4, 2009. Accepted for publication June 23, 2009.

Financial support: The Japan Society for Promotion of Sciences (JSPS) provided financial support to the first and second authors on international travel expenses to pursue this study on a collaborative basis.

* Address correspondence to Kittisak Sawanyawisuth, Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Friendship Road, Khon Kaen 40002, Thailand. E-mail: kittisak{at}kku.ac.th

Authors’ addresses: Kittisak Sawanyawisuth, Vichai Senthong, Panita Limpawattana, Somsak Tiamkao, Suthipun Jitpimolmard, and Verajit Chotmongkol, Department of Medicine, Faculty of Medicine, Srina-garind Hospital, Khon Kaen University, 123 Mitraparp Friendship Road, Khon Kaen, 40002, Thailand. Ken Takahashi, Tsutomu Hoshuyama, and Donald Wilson, Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishiku, Kitakyushu City, 807-8555, Japan. Kanlayanee Sawanyawisuth, Department of Biochemistry, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Friendship Road, Khon Kaen, 40002, Thailand. Pewpan M. Intapan, Department of Parasitology, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Friendship Road, Khon Kaen, 40002, Thailand.






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