ArticlePLoS neglected tropical diseases2020
Meningitis patients with Angiostrongylus cantonensis may present without eosinophilia in the cerebrospinal fluid in northern Vietnam.
Article in PLoS neglected tropical diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Review of the aetiologies of central nervous system infections in Vietnam.Frontiers in public health · 2024Pooled it
- Human Neuroangiostrongyliasis Caused by Angiostrongylus cantonensis in Northern Vietnam: a Clinical-Epidemiological Case Series of Eosinophilic Response and Disease Manifestations.Acta parasitologica · 2026Article
- An Outbreak of Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawai'i: Evidence Supporting the Early Use of Albendazole-Corticosteroid Co-Therapy.The American journal of tropical medicine and hygiene · 2026Article
- Article
- Eosinophilic meningitis caused by Angiostrongylus cantonensis: case report in a patient with false-positive immunological test result for Neisseria meningitides.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Central nervous system infection by Angiostrongylus cantonensis in children: experience from Guangdong, China.BMC infectious diseases · 2025Article
- Diagnosis of human angiostrongyliasis in a case of hydrocephalus using next-generation sequencing: a case report and literature review.BMC neurology · 2024Review
- Angiostrongylus cantonensis Nematode Invasion Pathway, Mallorca, Spain.Emerging infectious diseases · 2022Article
- Clinical Efficacy and Safety of Albendazole and Other Benzimidazole Anthelmintics for Rat Lungworm Disease (Neuroangiostrongyliasis): A Systematic Analysis of Clinical Reports and Animal Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Review
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14 authors at 7 institutions in 3 countries.
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Abstract
backgroundEosinophilic meningitis (EM) is a rare clinical syndrome caused by both infectious and noninfectious diseases. In tropical pacific countries, Angiostrongylus cantonensis is the most common cause. However, the EM definition varies in the literature, and its relation to parasitic meningitis (PM) remains unclear. METHODOLOGY/PRINCIPAL
findingsAdult and adolescent patients of 13 years old or above with suspected central nervous system (CNS) infections with abnormal CSF findings were prospectively enrolled at a tertiary referral hospital in Hanoi, Vietnam from June 2012 to May 2014. Patients with EM or suspected PM (EM/PM) were defined by the presence of either ≥10% eosinophils or an absolute eosinophil cell counts of ≥10/mm3 in the CSF or blood eosinophilia (>16% of WBCs) without CSF eosinophils. In total 679 patients were enrolled: 7 (1.03%) had ≥10% CSF eosinophilia, 20 (2.95%) had ≥10/mm3 CSF eosinophilia, and 7 (1.03%) had >16% blood eosinophilia. The patients with ≥10% CSF eosinophilia were significantly younger (p = 0.017), had a lower body temperature (p = 0.036) than patients with ≥10/mm3 CSF eosinophilia among whom bacterial pathogens were detected in 72.2% (13/18) of those who were tested by culture and/or PCR. In contrast, the characteristics of the patients with >16% blood eosinophilia resembled those of patients with ≥10% CSF eosinophilia. We further conducted serological tests and real-time PCR to identify A. cantonensis. Serology or real-time PCR was positive in 3 (42.8%) patients with ≥10% CSF eosinophilia and 6 (85.7%) patients with >16% blood eosinophilia without CSF eosinophils but none of patients with ≥10/mm3 CSF eosinophilia.
conclusionsThe etiology of PM in northern Vietnam is A. cantonensis. The eosinophil percentage is a more reliable predictor of parasitic EM than absolute eosinophil count in the CSF. Patients with PM may present with a high percentage of eosinophils in the peripheral blood but not in the CSF.
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