Ma Mingsheng, Zhang Mengqi, Qiu Zhengqing
Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2018 Jun;97(24):e10975. doi: 10.1097/MD.0000000000010975.
Parasitic eosinophilic meningitis is rarely observed in infants. The diagnosis of this disease is complicated by its atypical and severe clinical manifestations.
An infant presented to our hospital with high fever and irritability, as well as refusal to walk. Cerebrospinal fluid collected through lumbar puncture showed increased eosinophil count and third-stage Angiostrongylus cantonensis larvae.
Eosinophilic meningitis was suspected.
We started empiric treatment with levamisole (14 mg bid, 2.5 mg/kg·day) and prednisone (17.5 mg qd, 1.5 mg/kg·day).
All of the infant's symptoms were resolved approximately 72 hours after treatment. The patient fully recovered from her illness after completing 4 weeks of levamisole and prednisolone treatment.
A. cantonensis is the most common cause of parasitic eosinophilic meningitis cases in Southeast Asia. Physicians treating infants who live in areas where A. cantonensis is endemic and who present with irritability, abnormal motor function, and elevated eosinophil count should be aware of the disease to provide timely and rational therapy to the patients.
婴儿罕见寄生虫性嗜酸性粒细胞性脑膜炎。该疾病的非典型和严重临床表现使其诊断复杂化。
一名婴儿因高热、烦躁以及拒绝行走前来我院就诊。经腰椎穿刺采集的脑脊液显示嗜酸性粒细胞计数增加以及第三期广州管圆线虫幼虫。
怀疑为嗜酸性粒细胞性脑膜炎。
我们开始使用左旋咪唑（14毫克，每日两次，2.5毫克/千克·天）和泼尼松（17.5毫克，每日一次，1.5毫克/千克·天）进行经验性治疗。
治疗后约72小时，婴儿所有症状均得到缓解。完成4周的左旋咪唑和泼尼松龙治疗后，患者完全康复。
广州管圆线虫是东南亚地区寄生虫性嗜酸性粒细胞性脑膜炎病例的最常见病因。治疗居住在广州管圆线虫流行地区且出现烦躁、运动功能异常和嗜酸性粒细胞计数升高的婴儿的医生应了解该疾病，以便为患者提供及时合理的治疗。
