How to Differentiate Angiostrongylus cantonensis and Gnathostoma spinigerum as a cause of Eosinophilic Meningitis?
Meesing A, MD1,2, Peerabool C, MD1, Pitaknoppakul A, MD1, Thimachai P, MD1, Tiamkao S, MD1,3, Chotmongkol V, MD1, Sawanyawisuth K, MD, PhD1,4
Affiliation : 1 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 North-Eastern Stroke Research Group, Khon Kaen University, Khon Kaen University, Khon Kaen, Thailand 3 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand 4 Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, and Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
Objective : The common causes of eosinophilic meningitis are Angiostrongylus cantonensis and Gnathostoma spinigerum. To
differentiate both parasites can be performed by serology test. This study aimed to use clinical factors to differentiate cause of
eosinophilic meningitis from A. cantonensis or G. spinigerum.
Materials and Methods : The authors retrospectively reviewed clinical factors of eosinophilic meningitis patients who were tested
for A. cantonensis and G. spinigerum serology test at Srinagarind Hospital, Khon Kaen University, Thailand. Clinical factors were
compared by descriptive statistics.
Results : There were 33 eosinophilic meningitis patients who were tested for both parasites by serology tests. Of those, 22 patients
were positive for A. cantonensis, while 11 patients were positive for G. spinigerum. Patients with A. cantonensis had more headache
and fever, while patients with G. spinigerum had more migratory swelling, radicular pain, and abnormal Babinski’s sign. Regarding
laboratory tests, peripheral eosinophilia, numbers of white blood cells in the cerebrospinal fluid, and numbers of eosinophils in the
cerebrospinal fluid were not different between eosinophilic meningitis patients from A. cantonensis and G. spinigerum.
Conclusion : Clinical factors may be used to differentiate both parasites as a cause of eosinophilic meningitis.
Keywords : Eosinophilia, Migratory swelling, Radicular pain
