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[Headache after a stay in the Dominican Republic].
Dtsch Med Wochenschr. 2006 Jul 28; 131(30):1656-9.DM

Abstract

CASE HISTORY

In a 27-year-old female German patient severe headache and wandering paresthesias appeared one week after returning from a holiday in the Dominican Republic. After 3 weeks of ongoing symptoms she was admitted to our hospital with the suspicion of an inflammatory or infectious disease of the central nervous system. Upon admission slight stiffness of the neck, fever (38.2 C) and paresthesias of the right elbow and the right thigh were noticed.

LABORATORY FINDINGS

Cerebrospinal fluid (CSF) revealed an eosinophilic pleocytosis. In the acute phase of the disease, antibodies against nematodes were found in CSF, without corresponding antibody-reactivity in serum. In the course levels of nematode antibodies in CSF increased and antibody-reactivity in serum was observed. Thorough investigation for other infectious or inflammatory causes of eosinophilic meningitis revealed no abnormalities.

DIAGNOSIS, TREATMENT AND COURSE

Symptoms, onset within the typical incubation period and the eosinophilic meningitis lead to the diagnosis of a suspected Angiostrongyliasis. Successful treatment was achieved with a combination of oral albendazole and corticosteroids given for 4 weeks.

CONCLUSION

Infection with larvae of Angiostrongylus cantonensis is one of the main causes of eosinophilic meningitis worldwide. Human infection can occur after ingestion of intermediate hosts or contaminated vegetables. Angiostrongyliasis has been endemic to Southeast Asia and the Pacific Basin and only recently cases from the Caribbean have been described. Headache, paresthesias and the finding of an eosinophilic meningitis in patients returning from tropical or subtropical regions should lead to the suspicion and eventually the treatment of an Angiostrongyliasis.

Authors+Show Affiliations

Neurologische Klinik, Marienhospital Stuttgart. ChristophRau@vinzenz.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

16850382

Citation

Rau, C, et al. "[Headache After a Stay in the Dominican Republic]." Deutsche Medizinische Wochenschrift (1946), vol. 131, no. 30, 2006, pp. 1656-9.
Rau C, Bialek R, Richter S, et al. [Headache after a stay in the Dominican Republic]. Dtsch Med Wochenschr. 2006;131(30):1656-9.
Rau, C., Bialek, R., Richter, S., & Lindner, A. (2006). [Headache after a stay in the Dominican Republic]. Deutsche Medizinische Wochenschrift (1946), 131(30), 1656-9.
Rau C, et al. [Headache After a Stay in the Dominican Republic]. Dtsch Med Wochenschr. 2006 Jul 28;131(30):1656-9. PubMed PMID: 16850382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Headache after a stay in the Dominican Republic]. AU - Rau,C, AU - Bialek,R, AU - Richter,S, AU - Lindner,A, PY - 2006/7/20/pubmed PY - 2006/8/19/medline PY - 2006/7/20/entrez SP - 1656 EP - 9 JF - Deutsche medizinische Wochenschrift (1946) JO - Dtsch Med Wochenschr VL - 131 IS - 30 N2 - CASE HISTORY: In a 27-year-old female German patient severe headache and wandering paresthesias appeared one week after returning from a holiday in the Dominican Republic. After 3 weeks of ongoing symptoms she was admitted to our hospital with the suspicion of an inflammatory or infectious disease of the central nervous system. Upon admission slight stiffness of the neck, fever (38.2 C) and paresthesias of the right elbow and the right thigh were noticed. LABORATORY FINDINGS: Cerebrospinal fluid (CSF) revealed an eosinophilic pleocytosis. In the acute phase of the disease, antibodies against nematodes were found in CSF, without corresponding antibody-reactivity in serum. In the course levels of nematode antibodies in CSF increased and antibody-reactivity in serum was observed. Thorough investigation for other infectious or inflammatory causes of eosinophilic meningitis revealed no abnormalities. DIAGNOSIS, TREATMENT AND COURSE: Symptoms, onset within the typical incubation period and the eosinophilic meningitis lead to the diagnosis of a suspected Angiostrongyliasis. Successful treatment was achieved with a combination of oral albendazole and corticosteroids given for 4 weeks. CONCLUSION: Infection with larvae of Angiostrongylus cantonensis is one of the main causes of eosinophilic meningitis worldwide. Human infection can occur after ingestion of intermediate hosts or contaminated vegetables. Angiostrongyliasis has been endemic to Southeast Asia and the Pacific Basin and only recently cases from the Caribbean have been described. Headache, paresthesias and the finding of an eosinophilic meningitis in patients returning from tropical or subtropical regions should lead to the suspicion and eventually the treatment of an Angiostrongyliasis. SN - 0012-0472 UR - https://www.unboundmedicine.com/medline/citation/16850382/[Headache_after_a_stay_in_the_Dominican_Republic]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2006-947812 DB - PRIME DP - Unbound Medicine ER -