Sonakul D
Southeast Asian J Trop Med Public Health. 1978 Jun;9(2):220-7.
Three adults and a 3 1/2-year-old child presented with eosinophilic meningitis. A history of consumption of raw snails was elicited in 2; evidence of a constant diet of raw food, in the form of opisthorchiasis and taeniasis, as well as angiostrongyliasis, was present in the third; no history of raw food ingestion was obtained in the fourth, the child. Pathologic changes were similar in all 4 cases. There was infiltration of the meninges and around intracerebral vessels by varying proportions of lymphocytes, plasma cells and eosinophils. Numerous tracks and microcavities were found in the brains, and in the spinal cords in 2 cases, varying in size from 0.1 to 2 mm, and in age, with older tracks containing debris and gitter cells, newer tracks showing disruption of brain tissue, with and without haemorrhage. Numerous 4th and 5th stage Angiostrongylus larvae, alive and dead, were found in the meninges and brain tissue, sometimes in blood vessels or perivascular spaces, in 3 cases; in the fourth case a 5th stage larva was found on the surface of the right frontal lobe. In one case a degenerating larva was found in a pulmonary vessel. Cellular reaction was more often associated with dead larvae.
三名成年人及一名3岁半儿童出现嗜酸性粒细胞性脑膜炎。其中两名患者有食用生蜗牛史；第三名患者有以华支睾吸虫病、绦虫病以及广州管圆线虫病形式存在的持续生食习惯；第四名患者即该儿童没有生食摄入史。所有4例患者的病理变化相似。脑膜及脑内血管周围有不同比例的淋巴细胞、浆细胞和嗜酸性粒细胞浸润。在脑内发现大量虫道和微腔，2例脊髓内也有，大小从0.1毫米到2毫米不等，形成时间各异，较老的虫道含有碎屑和格子细胞，较新的虫道显示脑组织破坏，伴有或不伴有出血。在3例患者的脑膜和脑组织中发现大量活的和死的第四期和第五期广州管圆线虫幼虫，有时在血管或血管周围间隙中；在第四例患者的右额叶表面发现一条第五期幼虫。在一例患者的肺血管中发现一条退化的幼虫。细胞反应更多与死亡幼虫相关。
