Pien F D, Pien B C
Straub Clinic and Hospital, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, USA.
Int J Infect Dis. 1999 Spring;3(3):161-3. doi: 10.1016/s1201-9712(99)90039-5.
In the past 50 years, Angiostrongylus cantonensis, the most common cause of eosinophilic meningitis, has spread from Southeast Asia to the South Pacific, Africa, India, the Caribbean, and recently, to Australia and North America, mainly carried by cargo ship rats. Humans are accidental, "dead-end" hosts infected by eating larvae from snails, slugs, or contaminated, uncooked vegetables. These larvae migrate to the brain, spinal cord, and nerve roots, causing eosinophilia in both spinal fluid and peripheral blood. Infected patients present with severe headache, vomiting, paresthesias, weakness, and occasionally visual disturbances and extraocular muscular paralysis. Most patients have a full recovery; however, heavy infections can lead to chronic, disabling disease and even death. There is no proven treatment for this disease. In the authors' experience, corticosteroids have been helpful in severe cases to relieve intracranial pressure as well as neurologic symptoms due to inflammatory responses to migrating and eventually dying worms.
在过去50年里，嗜酸性粒细胞性脑膜炎最常见的病因——广州管圆线虫，已从东南亚传播至南太平洋、非洲、印度、加勒比地区，最近还传播到了澳大利亚和北美，主要通过货船鼠传播。人类是偶然的“终末”宿主，因食用来自蜗牛、蛞蝓或受污染的未煮熟蔬菜中的幼虫而感染。这些幼虫迁移至脑、脊髓和神经根，导致脑脊液和外周血嗜酸性粒细胞增多。感染患者表现为严重头痛、呕吐、感觉异常、虚弱，偶尔伴有视觉障碍和眼外肌麻痹。大多数患者可完全康复；然而，重度感染可导致慢性致残性疾病甚至死亡。这种疾病尚无经证实有效的治疗方法。根据作者的经验，在严重病例中，皮质类固醇有助于减轻颅内压以及因对迁移并最终死亡的蠕虫产生炎症反应而引起的神经症状。
