Eosinophilic Meningitis Due to<i>Angiostrongylus cantonensis</i>in a Returned Traveler: Case Report and Review of the Literature

Re, Vincent Lo; Gluckman, Stephen J.

doi:10.1086/323460

Cited by 29 publications

(2 citation statements)

References 21 publications

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“…Clinical exploration revealed that A. cantonensis invading human CNS caused eosinophilic meningitis and meningoencephalitis, and resulted in a serial of neurological symptoms, including persistent headache, paresthesia or hyperesthesia, nuchal rigidity, seizure, cognitive dysfunction, ataxic gait, and even unconsciousness [ 10 – 18 ]. These neurological symptoms were also identified in animals with A. cantonensis infection, which obviously presented lessening of the spontaneous activity and dysfunction for symmetry, balance and coordination of movements in infected rodents [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Neuronal Apoptosis: Pathological Basis of Behavioral Dysfunctions Induced by Angiostrongylus cantonensis in Rodents Model

et al. 2017

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Angiostrongylus cantonensis invades the central nervous system (CNS) of humans to induce eosinophilic meningitis and meningoencephalitis and leads to persistent headache, cognitive dysfunction, and ataxic gait. Infected mice (nonpermissive host), admittedly, suffer more serious pathological injuries than rats (permissive host). However, the pathological basis of these manifestations is incompletely elucidated. In this study, the behavioral test, histological and immunohistochemical techniques, and analysis of apoptotic gene expression, especially caspase-3, were conducted. The movement and motor coordination were investigated at week 2 post infection (PI) and week 3 PI in mice and rats, respectively. The cognitive impairs could be found in mice at week 2 PI but not in rats. The plaque-like lesion, perivascular cuffing of inflammatory cells, and dilated vessels within the cerebral cortex and hippocampus were more serious in mice than in rats at week 3 PI. Transcriptomic analysis showed activated extrinsic apoptotic pathway through increased expression of TNFR1 and caspase-8 in mice CNS. Immunohistochemical and double-labeling for NeuN and caspase-3 indicated the dramatically increased expression of caspase-3 in neuron of the cerebral cortex and hippocampus in mice but not in rats. Furthermore, western-blotting results showed high expression of cleaved caspase-3 proteins in mice but relatively low expression in rats. Thus, extrinsic apoptotic pathway participated in neuronal apoptosis might be the pathological basis of distinct behavioral dysfunctions in rodents with A. cantonensis infection. It provides the evidences of a primary molecular mechanism for the behavioral dysfunction and paves the ways to clinical diagnosis and therapy for A. cantonensis infection.

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Section: Introductionmentioning

confidence: 99%

Neuronal Apoptosis: Pathological Basis of Behavioral Dysfunctions Induced by Angiostrongylus cantonensis in Rodents Model

et al. 2017

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“…However, with increased globalism, this parasite has continued to spread to other parts of the world, including to the Americas, 4,12–14 with cases often identified in travelers returning from regions where angiostrongyliasis is endemic. 15–18 In the United States, angiostrongyliasis has been present in Hawaii since at least 1959. 19,20 However, recently, A. cantonensis has been found in both mollusk and rat hosts in the Gulf Coast region of the continental United States, 21–23 and sporadic autochthonous cases have been identified in other areas as well.…”

Section: Introductionmentioning

confidence: 99%

Review of Cases of Angiostrongyliasis in Hawaii, 2007–2017

Johnston

Dixon

Elm

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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. Angiostrongyliasis, caused by the Angiostrongylus cantonensis roundworm, became reportable in the state of Hawaii in 2007. We confirmed 82 reported cases between 2007 and 2017. There was a median of seven cases per year, and the majority (57%) of cases occurred between January and April. Most (83%) cases were found on the island of Hawaii, with geographic information system (GIS) analysis identifying hot spots on the east side of the island. However, cases were identified on the other major islands as well, suggesting the risk of exposure is present statewide. Comparisons of cases from 2007 to 2017 with cases from previous assessments found no statistical differences in cerebrospinal fluid results, peripheral blood results, or ages of cases. However, differences in geographic distribution of the cases were statistically significant. Improved testing and increasing awareness of the disease have contributed to our efforts to better understand the general risk factors and modes of transmission present in Hawaii and also helped improve our prevention efforts, although we still do not fully understand the specific causes of cases being concentrated in certain parts of the state over others. Continued outreach efforts, including public forums and publication of preliminary clinical guidelines, aim to inform and improve our public health response and efforts to prevent angiostrongyliasis.

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How to Interpret a CSF—The Art and the Science

Connell

Curtis

Advances in Experimental Medicine and Biology

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Eosinophilic Meningitis Due toAngiostrongylus cantonensisin a Returned Traveler: Case Report and Review of the Literature

Cited by 29 publications

References 21 publications

Neuronal Apoptosis: Pathological Basis of Behavioral Dysfunctions Induced by Angiostrongylus cantonensis in Rodents Model

Neuronal Apoptosis: Pathological Basis of Behavioral Dysfunctions Induced by Angiostrongylus cantonensis in Rodents Model

Review of Cases of Angiostrongyliasis in Hawaii, 2007–2017

How to Interpret a CSF—The Art and the Science

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