Tags

Type your tag names separated by a space and hit enter

Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe.
Int J Infect Dis. 2020 Apr; 93:28-39.IJ

Abstract

OBJECTIVES

To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe.

METHODS

A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data.

RESULTS

Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended.

CONCLUSIONS

We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated.

Authors+Show Affiliations

Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom. Electronic address: frederik.federspiel@lshtm.ac.uk.Department of Microbiology, Odense University Hospital, Søndre Blvd. 29, 5000 Odense C, Denmark. Electronic address: sofie.skovmand.rasmussen@rsyd.dk.Clinical Centre of Emerging and Vector-borne Infections, Department of Infectious Diseases, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Søndre Blvd. 29, 5000 Odense C, Denmark. Electronic address: s.skarphedinsson@rsyd.dk.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31972289

Citation

Federspiel, Frederik, et al. "Eosinophilic Meningitis Due to Angiostrongylus Cantonensis in Europe." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 93, 2020, pp. 28-39.
Federspiel F, Skovmand S, Skarphedinsson S. Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. Int J Infect Dis. 2020;93:28-39.
Federspiel, F., Skovmand, S., & Skarphedinsson, S. (2020). Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 93, 28-39. https://doi.org/10.1016/j.ijid.2020.01.012
Federspiel F, Skovmand S, Skarphedinsson S. Eosinophilic Meningitis Due to Angiostrongylus Cantonensis in Europe. Int J Infect Dis. 2020;93:28-39. PubMed PMID: 31972289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. AU - Federspiel,Frederik, AU - Skovmand,Sofie, AU - Skarphedinsson,Sigurdur, Y1 - 2020/01/20/ PY - 2019/09/18/received PY - 2020/01/03/revised PY - 2020/01/13/accepted PY - 2020/1/24/pubmed PY - 2020/6/20/medline PY - 2020/1/24/entrez KW - Angiostrongylus cantonensis KW - Eosinophilic meningitis KW - Europe SP - 28 EP - 39 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 93 N2 - OBJECTIVES: To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe. METHODS: A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data. RESULTS: Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended. CONCLUSIONS: We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/31972289/Eosinophilic_meningitis_due_to_Angiostrongylus_cantonensis_in_Europe_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(20)30014-X DB - PRIME DP - Unbound Medicine ER -