Campos, Lillian Gonçalves

Duarte, Juliana Ávila

Massena, João Ricardo Hass

International Journal of Infectious Diseases

English

Lume 5.8

International Journal of Infectious Diseases 100 (2020) 237–238Medical ImageryCase of eosinophilic meningitis in an autistic childContents lists available at ScienceDirectInternational Journal of Infectious Diseasesjournal home page: www.elsevier .com/ locat e/ i j idAn eight-year-old boy, autistic and with a history of unusualeating habits (like live snails), was brought to the hospital withsleepiness, nausea and vomiting. At the beginning he also had ageneralized seizure.His white blood count cells showed a leukocytosis with eosinophilia.Lumbar puncture was performed and his cerebrospinal fluid (CSF)showed 530 leukocytes with 64% of eosinophils. The result of the CSFanalysis detected Angiostrongylus cantonensis antibodies and antigen(methods ELISA IgG and Western Blot). The diagnosis of eosinophilicmeningitis caused by that nematode was done. Albendazole andsteroids were used for treatment, with clinical improvement.Magnetic resonance imaging (MRI) was also performed(Figures. 1 and 2).Figure 1. Some punctate foci of diffusion (DWI) restrictiohttps://doi.org/10.1016/j.ijid.2020.09.0011201-9712/© 2020 The Author(s). Published by Elsevier Ltd on behalf of International Solicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).Multiple scattered hyperintensities with and without con-trast enhancement are the most commonly described findingson MRI (Rai et al., 2014). Sometimes computed tomogram (CT)and MRI may not reveal any abnormality (Rai et al., 2014). Thefinding on diffusion weighted-imaging (DWI) can represent fociof microabscesses or developing infarcts and is not commonlydescribed in the literature (Rai et al., 2014; Federspiel et al.,2020).The final diagnosis of neuroangiostrongyliasis is based onserology and CSF cell counts (Rai et al., 2014). In this case, theunusual eating habits could increase the suspect, once Angios-trongylus cantonensis is an emerging parasite in Brazil and can befound in snails (Morassuti et al., 2014).n in supra and infratentorial compartments (arrows).ciety for Infectious Diseases. This is an open access article under the CC BY-NC-NDFigure 2. Diffuse leptomeningeal enhancement (thick arrows on post-contrast T1) and sulcal FLAIR hyperintensity (thin arrows). Ectasic ventricles were also found (notshown).238 L.G. Campos et al. / International Journal of Infectious Diseases 100 (2020) 237–238Authors contributionsLillian Gonçalves Campos and João Ricardo Hass Massena:Collected data, contributed data and wrote the paper.Juliana Ávila Duarte: Conceived the ideia, contributed data andreviewed the paper.Conflict of interestNone declare.Funding sourceNone.Ethical approvalWritten informed consent was obtained from the patient.Patient’s data was anonymized.ReferencesFederspiel F, Skovmand S, Skarphedinsson S. Eosinophilic meningitis due toAngiostrongylus cantonensis in Europe. Int J Infect Dis 2020;93:28–39.Morassuti AL, Thiengo SC, Fernandez M, Sawanyawisuth K, Graeff-Teixeira C.Eosinophilic meningitis caused by Angiostrongylus cantoenensis: an emergentdisease in Brazil. Mem Inst Oswaldo Cruz 2014;109:339–407.Rai S, Madi D, Pai S, Baliga S. Unusual larva in the CSF and unique MRI findings in acase of eosinophilic meningitis. J Clin Imaging Sci 2014;4:76.Lillian Gonçalves Camposa,*João Ricardo Hass MassenabJuliana Ávila DuartecaServiço de Radiologia do Hospital de Clínicas de Porto Alegre, PortoAlegre, RS, BrazilbUnisinos, Curso de Medicina, Porto Alegre, RS, BrazilcUniversidade Federal do Rio Grande do Sul, Programa de PósGraduação em Ciências Médicas, Departamento de Medicina Interna,Porto Alegre, RS, Brazil* Corresponding author.E-mail address: lgcampos@hcpa.edu.br (L. Campos).Received 11 August 2020Received in revised form 27 August 2020Accepted 1 September 2020

Medical imagery : case of eosinophilic meningitis in an autistic child

https://lume.ufrgs.br/bitstream/10183/216235/1/001119071.pdf

Medical imagery : case of eosinophilic meningitis in an autistic child

Abstract

Similar works

Full text

Available Versions

Lume 5.8