Significant elevations of IOP are experienced during robotic surgery utilizing sTBURG positioning in patients with healthy eyes, and we recommend a multidisciplinary approach in determining potential risk to those with known ocular disease who are candidates for these procedures.
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.
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