Tang Xiaomiao, Wu Juanjuan, Yang Yefeng, Wang Yingqiong, Jin Chengji, Xie Chengzhi, Wang Mei, Liu Run, Wang Xiaozhi, Wang Fengyun, Wang Jing
Department of Respiratory Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Department of Critical Care Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou, China.
J Infect Public Health. 2025 May;18(5):102759. doi: 10.1016/j.jiph.2025.102759. Epub 2025 Mar 17.
Angiostrongylus cantonensis (AC) is a parasite that occasionally infects humans, causing eosinophilic meningitis (EM). In this study, we identified two adult males with severe angiostrongyliasis being treated at the ICU. Both presented with mental and behavioral abnormalities and were initially treated for psychiatric disorders before showing symptoms like cough, fever, and altered consciousness. Patient 1, a homeless individual, presented with elevated eosinophil levels and typical meningitis symptoms, prompting an early diagnosis of EM that was later confirmed via next-generation sequencing (NGS) of the cerebrospinal fluid. Patient 2, who had schizophrenia as a pre-existing condition, did not exhibit the typical signs of meningitis but was nonetheless detected via NGS. Both patients responded well to corticosteroids and anthelmintics. A review of case reports underscores heightened infection risks among children with pica and vulnerable adults, including those with mental disorders or homelessness. The use of NGS is effective for the early diagnosis and treatment of severe angiostrongyliasis, especially in those with atypical symptoms.
广州管圆线虫（AC）是一种偶尔会感染人类并导致嗜酸性粒细胞性脑膜炎（EM）的寄生虫。在本研究中，我们在重症监护病房（ICU）识别出两名患有严重管圆线虫病的成年男性。两人均出现精神和行为异常，最初因精神疾病接受治疗，之后才出现咳嗽、发热和意识改变等症状。患者1是一名无家可归者，嗜酸性粒细胞水平升高且有典型的脑膜炎症状，促使早期诊断为EM，随后通过脑脊液的下一代测序（NGS）得以确诊。患者2既往患有精神分裂症，未表现出典型的脑膜炎体征，但仍通过NGS检测出来。两名患者对皮质类固醇和驱虫药反应良好。对病例报告的回顾强调，患有异食癖的儿童和易感染的成年人，包括那些患有精神疾病或无家可归者，感染风险更高。NGS的使用对严重管圆线虫病的早期诊断和治疗有效，尤其是对那些有非典型症状的患者。
