Eosinophilic meningoencephalitis outbreak in a rural community

[摘要] INTRODUCTION: the infection by nematode Angiostrongylus cantonensis is the most frequent cause of eosinophilic meningoencephalitis. Most of cases occur in isolation although numerous outbreaks have been described.OBJECTIVES: to describe the clinical manifestations and the characteristics of the cerebrospinal fluid and other supplementary exams from 11 patients diagnosed as eosinophilic meningoencephalitis carriers.METHODS: a case study of eleven patients diagnosed with eosinophilic meningoencephalitis and admitted to "Dr. Gustavo Aldereguía Lima" general university hospital. These patients worked at the same workplace located in a rural area and their clinical symptoms appeared in the same period of time (january to february, 2006).RESULTS: predominant symptoms were persistent headache (100 % of cases 9, cutaneous paresthesia and hyperesthesia (100 %), myalgias (45 %), impaired vision (45 %), neck rigidity (18 %), peripheral facial paralysis in two cases (18 %). One single patient said that he had got fever.CONCLUSIONS: Meningoencephalitis caused by A. cantonensis should be suspected whenever a person suffers from persistent headache, paresthesias and hyperesthesias, even when neither fever nor neck rigidity is declared. Eosinophilia in peripheral blood associated to previous symptoms may indicate such a diagnosis. Pleocytosis, in which the percentage of eosinophils is high, is a characteristic of this disease; however, the lack of eosinophils in the cerebrospinal fluid does not reject this diagnosis. It is frequent that at some stage, lymphocytes will be predominant. The description of this case study allows us to present the first report of an outbreak of eosinophilic meningoencephalitis occurred in Cuba.

[学科分类] 传染病学

[关键词] : eosinophilic meningoencephalitis;Angiostrongylus cantonensis;eosinophilia