A Neurotoxocariasis Case Manifesting Multiple Cerebral Infarction and Eosinophilic Meningoencephalitis

Although Toxocara canis is known to cross the blood-brain barrier, central nervous system involvement is uncommon. Clinical manifestations vary and include cerebral infarction, meningoencephalitis, myelitis, vasculitis or seizure. However cerebral infarction and meningoencephalitis rarely occur simultaneously. We report a case of multiple cerebral infarction combined with eosinophilic meningoencephalitis in a patient with neurotoxocariasis. After control of increased intracranial pressure and treatment with albendazole and steroid, the patient’s clinical symptoms improved markedly.

A Case Report of Slug Ingestion Causing Eosinophilic Meningitis, Papilledema, and Pronounced Motor Weakness in a US Marine

Angiostrongyliasis is the most common cause of eosinophilic meningitis worldwide and is primarily characterized by eosinophilic meningitis, meningoencephalitis, or myelitis. It is caused by ingestion of the nematode Angiostrongylus cantonensis, the rat lungworm (or apple snail). The most common route of infection is by ingestion of parts of the intermediate hosts like mollusks or food contaminated with infective third stage larvae. Following ingestion, the larvae migrate through the intestinal walls into the bloodstream and further into the central nervous system where they cause meningo-encephalo-myelitis and can have a variety of ocular manifestations. We present a case of a Caucasian United States Marine who suffered severe meningo-encephalo-myelitis with papilledema following ingestion of a raw Giant African Snail (Lissachatina lutica) while stationed in Japan. He developed eosinophilic meningoencephalitis, polyneuropathy, motor weakness, and papilledema. We describe the unique clinical features of this disease in our patient.

Severe Eosinophilic Meningoencephalitis Secondary to Suspected Neuroangiostrongyliasis with a Good Clinical Outcome

Angiostrongylus cantonensishas caused sporadic cases of eosinophilic meningoencephalitis in Sydney, Australia. We describe a 36-year-old man who presented subacutely with fevers, reduced level of consciousness, confusion, ophthalmoplegia, and urinary incontinence. He was diagnosed with severe eosinophilic meningoencephalitis secondary to suspectedAngiostrongylus cantonensisbased on clinical, serological, and radiological findings. The patient was treated with albendazole and prednisolone with full neurological recovery. Management of neuroangiostrongyliasis with anthelminthic is controversial as it is thought to cause worsened outcomes through inciting an inflammatory response as a result of parasite killing. We managed to successfully treat our patient using albendazole and prednisolone and achieved a good outcome.