Kaiser Permanente, Honolulu, Hawai'i.
University of Hawai'i John A. Burns School of Medicine, Honolulu, Hawai'i.
Am J Trop Med Hyg. 2022 Jul 5;107(2):367-369. doi: 10.4269/ajtmh.22-0199. Print 2022 Aug 17.
Angiostrongylus cantonensis is an emerging parasite that is the most common cause of eosinophilic meningitis worldwide. Human infection typically presents with headache, neck stiffness, and paresthesia. We report a case of a woman with PCR positive A. cantonensis infection who presented with symptoms of small fiber neuropathy (SFN) but no headache. SFN was confirmed by skin biopsy. After failing standard medications for neuropathy, she was treated with intravenous lidocaine with considerable improvement. However, she required medications for 1 year to treat her chronic neuropathy. Infection by A. cantonensis should be added to the list of causes of SFN, and its potential to cause chronic sequelae should be appreciated.
广东血管圆线虫是一种新兴的寄生虫，是世界范围内引起嗜酸性粒细胞性脑膜炎的最常见原因。人类感染通常表现为头痛、颈部僵硬和感觉异常。我们报告了一例 PCR 阳性广东血管圆线虫感染的女性患者，她表现为小纤维神经病（SFN）的症状，但没有头痛。SFN 通过皮肤活检得到证实。在标准的神经病变药物治疗失败后，她接受了静脉利多卡因治疗，症状有了相当大的改善。然而，她需要服用药物 1 年来治疗慢性神经病变。广东血管圆线虫感染应被列入 SFN 的病因清单，并应认识到其引起慢性后遗症的潜力。
