A case of eosinophilic meningitis (original) (raw)
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Eosinophilic Meningitis in a 10-Year Old Nigerian Boy: A Case Report
African Journal of Infectious Diseases, 2013
Eosinophilic meningitis is rare, commonly caused by invasion of the central nervous system by helminthes. The present case is that of a 10-year-old boy who presented with history of generalized pruritus not associated with skin eruptions, followed by pain and weakness of the extremities and loss of consciousness. Patient did not receive BCG vaccination. Initial clinical evaluation was suggestive of tuberculous meningitis but cerebrospinal fluid analysis revealed eosinophilic meningitis. Patient made remarkable improvement with treatment with no sequel.
A rare case of eosinophilic meningitis
International Journal of Contemporary Pediatrics
Eosinophilic meningitis is a rare form of meningitis, usually caused by helminthic infection and the most common agent is Angiostrongylus cantonensis. It has a variable clinical presentation that ranges from cranial nerve abnormalities, ataxia, meningitis, encephalitis and rarely death. As the literature and reviews on this topic are rare, the standard treatment for eosinophilic meningitis caused by A. cantonensis infection has always been controversial. There is evidence that a 2-week course of high dose corticosteroid along with albendazole have helped in management. Here we discuss the case of a toddler with eosinophilic meningitis with Angiostrongylus species.
Folia Microbiologica, 2009
A very rare clinical entity, so-called eosinophilic meningitis, classified by prevalence of eosinophils in cerebrospinal fluid (CSF), with the presence of pleiocytosis, has been recorded in our laboratory four times only in the last 24 years. A low glucose level, elevation of total protein and lactic acid in CSF were detected in all the clinical cases. The last two cases were made possible by using flow cytometry method; surprisingly, the presence was found in mature T-cells in CSF, predominantly helpers (CD3+, CD4+) and, practically, none is B-cells (CD19+), plasma cells (CD138+) and NK-cells.
Síndrome de sensibilidad a fármacos con eosinofilia y síntomas sistémicos en pediatría. Caso clínico
Revista Chilena de Pediatría, 2016
Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially lifethreatening, drug-induced hypersensitivity reaction that includes skin eruptions, fever, lymphadenopathy, hematological abnormalities, and internal organ involvement. Objective: To present a rare condition in children; to facilitate a rapid diagnostic suspicion and recognition by doctors. Case report: A 9 months old infant admitted due to a severe viral pneumonia, treated with non-invasive ventilation and ceftriaxone, among other medications. Five days after stopping antibiotics, a violetcolored maculopapular rash appeared, confluent predominantly in the trunk, face and upper extremities, combined with a fever, eosinophilia, and elevated transaminases. She was treated with oral prednisone and topical corticosteroids for 6 weeks, with good results at 3 months follow-up. Conclusions: The diagnosis of DRESS syndrome is made using clinical criteria and laboratory examinations, as well as a skin biopsy in the case of any doubt in the diagnostics. Although it is most frequently caused by anticonvulsants, many other drugs have been implicated. Management consists of discontinuing the suspected drug associated with the reactions and a prolonged treatment of corticosteroids.
Eosinophils and Parasitic Infections
International Journal of Enteric Pathogens
Background: Eosinophils dysregulate immune responses associated with malignancies, allergic and parasitic diseases especially helminthic infections, though it is infrequently observed with protozoan diseases. Objective: The aim of the present study was to evaluate and compare the percentage of eosinophils in different parasitic diseases at Baqiyatallah Hospital, Tehran, Iran. Materials and Methods: One hundred and 72 samples were obtained from 74 and 98 patients with helminthic and protozoan diseases respectively and evaluated. Direct wet mount and formalin ether concentration were used for intestinal parasites identification. Scotch tape test and serological methods were utilized for diagnosis of Enterobius vermicularis and tissue parasites respectively. Eosinophils were counted and six or more percentages were considered as eosinophilia. Results: In general, in 34 out of 74 helminthic infections (45.9%) and 5 out of 98 protozoan infections (5.1%), an eosinophil level equal or more than 6% was observed. The rate of eosinophilia in helminthic infections were 13/18 (72.2%), 7/11 (63.6%), 3/10 (30%), 2/3 (66.7%), 1/9 (11.11%), 5/13 (38.5%), 3/4 (75%) in the patients with fasciolosis, strongyloidiasis, hymenolepiasis, hookworm infection, enterobiasis, echinococcosis, and trichostrongyliasis, respectively. Concerning the protozoan infections, 3/26(11.5%) and 2/20(10%) of the individuals suffering from giardiasis and blastocystosis showed an eosinophil level higher than normal range, respectively. Conclusion: As expected, helminthic infections especially fasciolosis and strongyloidiasis were the most important infections correlated with eosinophilia. According to available reports, eosinophilia higher than normal range in giardiasis and blastocystosis is not unexpected.
Idiopathic Eosinophilic Meningoencephalomyelitis Following Well Syndrome
2009
Eosinophilic meningitis is an uncommon condition often associated with helminthic infections. We present a patient with idiopathic eosinophilic meningoencephalomyelitis occurring 9 months after an episode of Well syndrome, an idiopathic eosinophilic cellulitis. The disorder mimics Gordon phenomenon, an experimentally induced encephalitis in animals associated with eosinophil-derived neurotoxicity. Case report. A 55-year-old woman developed a rash on her legs. Skin biopsy revealed an eosinophilic cellulitis consistent with Well syndrome (figure, A and B). A peripheral eosinophilia of 1,134 cells/L was present. The cellulitis resolved with a short course of oral steroids, and the eosinophilia diminished. Nine months later, she developed vertigo and ataxia, followed by progressive dysarthria, double vision, headache, and tinnitus. A peripheral eosinophilia of 1,900 cells/L was present. An initial brain MRI was unremarkable. Two weeks later, the MRI showed mild leptomeningeal enhancement and 2 globoid temporal white matter lesions. The CSF revealed a lymphocytic pleocytosis with 140 white blood cells and protein of 104 mg/dL. Three weeks later, the eosinophilic fraction increased (351 cells; 81% lymphocytes, 8% eosinophils, 8% monocytes). Cytology was negative for malignancy. A FiP1L1 platelet-derived growth factor receptor test was negative, making eosinophilic leukemia unlikely. 1 After a short course of empiric IV methylprednisolone, the patient was transferred to our hospital. On admission, 5 weeks after onset, her examination revealed cerebellar dysarthria, extremely slow saccades in all directions, profound dysmetria, and gait ataxia. Despite an empiric course of albendazole, these findings gradually worsened, and she developed downbeat nystagmus and mild left hemiparesis. Serial CSF examination revealed 76, 78, and 61 white blood cells, with an increasing eosinophilic fraction (4%, 24%, 33%). Oligoclonal bands were present. An infectious evaluation was negative for strongyloides, toxocara, Bartonella, enterovirus, Whipple, coccidiomycosis, cysticercosis, Epstein-Barr virus, cytomegalovirus, varicella zoster virus, JC virus, par
Eosinophilia with Special Reference to Helminthiasis
Journal of the Egyptian Society of Parasitology, 2018
Eosinophilia (e-o-sin-o-FILL-e-uh) is a higher than normal level of eosinophils. Eosinophils are a type of disease-fighting white blood cell, indicating a parasitic infection, an allergic reaction or cancer. There are blood eosinophilia and tissue eosinophilia. Tissue eosinophilia may be found in samples taken during an exploratory procedure or in samples of certain fluids, such as mucus released from nasal tissues. If you have tissue eosinophilia, the level of eosinophils in your bloodstream is likely normal. Blood eosinophilia may be detected with a blood test, usually as part of a complete blood count. More than 500 eosinophils per microliter of blood is generally considered eosinophilia in adults. More than 1,500 eosinophils per microliter of blood that lasts for several months is called hypereosinophilia. This reviewed the correlation between high eosinophila and helminthiasis.
Case Reports in Gastroenterology, 2011
We report the case of a 24-year-old male patient admitted for recent ascites and splenomegaly of unknown origin. The patient was referred to our institution with complaints of diarrhea, epigastric pain, abdominal cramping and weight loss over the past three weeks. The acute onset presented with colicky abdominal pain and peritoneal effusion. History revealed reduced appetite and weight gain of 7 kg over the last one month. His past medical history and family history was negative. He had no history of alcohol abuse or viral hepatitis infection. Laboratory data revealed normal transaminases and bilirubin levels, and alkaline phosphatase and gammaglutamyltransferase were within normal range. A diagnostic laparoscopy was performed which showed free peritoneal fluid and normal abdominal viscera. Upper gastrointestinal system endoscopy performed a few days later revealed diffuse severe erythematous pangastritis and gastroduodenal gastric reflux. Duodenal biopsies showed chronic nonspecific duodenitis. Antrum and corpus biopsies showed chronic gastritis. The ascitic fluid was straw-colored and sterile with 80% eosinophils. Stool exam was negative for parasitic infection. Treatment with albendazole 400 mg twice daily for 5 days led to the disappearance of ascites and other signs and symptoms. Three months after albendazole treatment the eosinophilic cell count was normal. The final diagnosis was consistent with parasitic infection while the clinical, sonographic and histological findings suggested an eosinophilic ascites. We emphasize the importance of excluding parasitic infection in all patients with eosinophilic ascites. We chose an alternative way (albendazole treatment) to resolve this clinical picture. With our alternative way for excluding this parasitic infection, we treated the patient and then found the cause.