Volume 68, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


is the most common cause of eosinophilic meningitis worldwide. Human infection occurs after ingestion of the worms in raw snails or fish that serve as intermediate hosts. Two outbreaks of central nervous system infection with occurred in Kaoshiung, Taiwan, during 1998 and 1999 among Thai laborers who ate raw snails. A detailed clinical studies of 17 of these patients was conducted, including study of 13 patients who underwent magnetic resonance imaging (MRI) scans of the brain. The MRI scans revealed high signal intensities over the globus pallidus and cerebral peduncle on TI-weighted imaging, leptomeningeal enhancement, ventriculomegaly, and punctate areas of abnormal enhancement within the cerebral and cerebellar hemisphere on gadolinium-enhancing T1 imaging, and a hyperintense signal on T2-weighted images. There was a significant correlation between severity of headache, cerebrospinal fluid (CSF) pleocytosis, and CSF and blood eosinophilia with MRI signal intensity in T1-weighted imaging ( < 0.05). Eosinophilic meningitis produced by needs to added to the list of causes of hyperintense basal ganglia lesions found on T1-weighted MRI scans in tropical countries.


Article metrics loading...

Loading full text...

Full text loading...



  1. Nye SW, Tangchai P, Sundarakiti S, Punyagupta S, 1970. Lesions of the brain in eosinophilic meningitis. Arch Pathol Lab Med 89 : 9–19.
  2. Koo J, Pien FK, Liks MM, 1988. Angiostrongylus (Parastrongylus) eosinophilic meningitis. Rev Infect Dis 10 : 1155–1162.
  3. Enzenauer RW, Yamaoka RM, 1982. Eosinophilic meningitis and hydrocephalus in an infant. Arch Neurol 39 : 380–381.
  4. Prociv P. Tiernan JR, 1987. Eosinophilic meningoencephalitis with permanent sequelae. Med J Aust 147 : 294–295.
  5. Ko RC, Chiu MC, Kum W, Chan SH, 1984. First report of human angiostrongyliasis in Hong Kong diagnosed by computerized axial topography (CAT) and enzyme linked immunosorbent assay. Trans R Soc Trop Med Hyg 78 : 354–355.
  6. Purohit AK, Dinakar I, Sundaram C. Ratnakar KS, 1991. Angiostrongylus cantonensis abscess in the brain. J Neurol Neurosurg Psychiatry 54 : 1015–1016.
  7. Noskin GA, McMenamin MB, Grohmann SM, 1992. Eosinophilic meningitis due to Angiostrongylus cantonensis. Neurology 42 : 1423–1424.
  8. Hsu WY, Chen JY, Chien CT, Chi CS, Han NT, 1990. Eosinophilic meningitis caused by Angiostrongylus cantonensis. Pediatr Infect Dis J 9 : 443–445.
  9. Kanpittaya J, Jitpimolmard S, Tiamkao S, Mairiang E, 2000. MR findings of eosinophilic meningoencephalitis attributed to Angiostrongylus cantonensis. Am J Neuroradiol 21 : 1090–1094.
  10. Sonakul D, 1978. Pathological findings in four cases of human angiostrongyliasis. Southeast Asian J Trop Med Pubic Health 9 : 220–227.
  11. Tsai TH, Liu YC, Wann SR, Lin WR, Susan Lee SJ, Lin HH, Chen YS, Yen MY, Yen CM, 2001. An outbreak of meningitis caused by Angiostrongylus cantonensis in Kaohsiung. J Microbiol Immunol Infect 34 : 50–56.
  12. Tsai HC, Liu YC, Kunin CM, Susan Lee SJ, Chen YS, Lin HH, Tsai TH, Lin WR, Huang CK, Yen MY, Yen CM, 2001. Eosinophilic meningitis caused by Angiostrongylus cantonensis: report of seventeen cases. Am J Med 111 : 109–114.
  13. Chye SM, Chang JH, Yen CM, 2000. Immunodiagnosis of human eosinophilic meningitis using an antigen of Angiostrongylus cantonensis L5 with molecular weight 204 kd. Acta Trop 75 : 9–17.
  14. Mehlisch DR, Weaver M, Fladung B, 1998. Ketoprofen, acetaminophen, and placebo in the treatment of tension headache. Headache 38: 579–589.
  15. Laker M, 1982. On determining trace element levels in man: the uses of blood and hair. Lancet 8292 : 260–262.
  16. Chen HT, 1935. Un nouveau nematode pulmonaire, Pulmonema cantonensis n.g.n.sp., des rats de Canton. Ann Parasitol Hum Comp 13 : 312–317.
  17. Beaver PC, Rosen L, 1945. Memorandum on the first report of Angiostrongylus in man by Nomura and Lin. Am J Trop Med Hyg 13: 588–590.
  18. Nomura S, Lin PH, 1945. First case report of human infection with Hamostrongylus ratti Yokogawa. Taiwan No Ikai 3 : 589–592.
  19. Jindrak K, Alicata JE, 1965. A case of parasitic eosinophilic meningoencephalitis in Vietnam probably caused by Angiostrongylus cantonensis. Ann Trop Med Parasitol 59 : 294.
  20. Tangchai P, Nye SW, and Beaver PC, 1967. Eosinophilic meningoencephalitis caused by angiostrongyliasis in Thailand. Am J Trop Med Hyg 16: 454–461.
  21. Punyagupta S, Juttijudata P, Bunnag T, 1975. Eosinophilic meningitis in Thailand: clinical studies of 484 typical cases probably caused by Angiostrongylus. Am J Trop Med Hyg 24 : 921–931.
  22. Yii CY, 1976. Clinical observations on eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis on Taiwan. Am J Trop Med Hyg 25 : 233–249.
  23. Fell JM, Reynolds AP, Meadows N, Khan K, Long SG, Quaghebeur G, Taylor WJ, Milla PJ, 1996. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 347 : 1218–1221.
  24. Krieger D, Krieger S, Jansen O, Gass P, Theilmann L, Lichtnecker H, 1995. Manganese and chronic hepatic encephalopathy. Lancet 346 : 270–274.
  25. Hauser RA, Zesiewicz TA, Rosemurgy AS, Martinez C, Olanow CW, 1994. Manganese intoxication and chronic liver failure. Ann Neurol 36: 871–875.
  26. Lai PH, Chen C, Liang HL, Pan HB, 1999. Hyperintense basal ganglia on T1-weighted MR imaging. AJR Am J Roentgenol 172 : 1109–1115.

Data & Media loading...

  • Received : 19 Jun 2001
  • Accepted : 18 Nov 2002

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error