Clinical Factors Predictive of Encephalitis Caused by Angiostrongylus cantonensis

Kittisak Sawanyawisuth 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

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Ken Takahashi 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

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Tsutomu Hoshuyama 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

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Kanlayanee Sawanyawisuth 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

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Vichai Senthong 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

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Panita Limpawattana 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

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Pewpan M. Intapan 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

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Donald Wilson 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

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Somsak Tiamkao 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

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Suthipun Jitpimolmard 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

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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

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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.

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