Graber D, Jaffar M C, Attali T, Poisson J, Renouil M, Alessandri J L, Combes J C
Service de pédiatrie, Centre hospitalier départemental F. Guyon, St. Denis, France.
Bull Soc Pathol Exot. 1997;90(5):331-2.
Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT 1: A 11 months old boy living in Mayotte island was hospitalized some days after fever and skin rash with seizure status, coma, flaccid quadriplegia, absence of deep tendon reflexes, urinary retention and anal incontinence. Eosinophilia was observed in peripheral blood and in the cerebrospinal fluid. Secondary, he developed a triventricular hydrocephalus treated by a ventriculoperitoneal shunt. After 3 weeks, the child died. Retrospectively, the diagnosis of angiostrongylus infection was established with the help of serology. CASE REPORTS 2 AND 3: Two infants, 10 and 11 months old boys, living in Reunion island, developed fever and vomitings, irritability and, for one of them, a unilateral sixth cranial nerve palsy. There was eosinophilia in the peripheral blood and in the cerebrospinal fluid. All symptoms progressively disappeared with complete recovery. The suspected diagnosis of angiostrongylus infection was confirmed by the serology.
We report the first case of Angiostrongylus cantonensis infection in the French island of Mayotte (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms. The origin of these occasionally massive infections is the giant African snail Achatina fulica. For a child with meningitis living in Reunion or Mayotte, or coming back from these 2 islands, Angiostrongylus cantonensis infection must be evoked, especially if there is a blood eosinophilia. Since efficiency of antiparasitic treatment is nowadays not proved, information must be given to people living in exposed areas in view to limit incidence of this disease.
由广州管圆线虫引起的嗜酸性粒细胞性脑膜炎在东南亚和太平洋岛屿广泛存在。成人会患上具有良性病程的短暂性脑膜炎，但儿科患者可能会出现严重或致命疾病。病例报告1：一名居住在马约特岛的11个月大男孩，在发热和皮疹几天后因癫痫持续状态、昏迷、弛缓性四肢瘫、腱反射消失、尿潴留和肛门失禁入院。外周血和脑脊液中均观察到嗜酸性粒细胞增多。其次，他发展为三脑室脑积水，接受了脑室腹腔分流术治疗。3周后，患儿死亡。回顾性分析，借助血清学确诊为管圆线虫感染。病例报告2和3：两名分别为10个月和11个月大的男孩，居住在留尼汪岛，出现发热、呕吐、易激惹症状，其中一名还出现单侧第六颅神经麻痹。外周血和脑脊液中存在嗜酸性粒细胞增多。所有症状逐渐消失，完全康复。血清学证实了疑似管圆线虫感染的诊断。
我们报告了法国马约特岛（科摩罗群岛）首例广州管圆线虫感染病例，并证实留尼汪岛存在这种疾病。在这个印度洋地区，嗜酸性粒细胞性脑膜炎大多发生在婴儿中，有时会出现严重的神经根脊髓脑炎性形式。这些偶尔大量感染的源头是巨型非洲蜗牛褐云玛瑙螺。对于居住在留尼汪岛或马约特岛、或从这两个岛屿返回的患有脑膜炎的儿童，必须考虑广州管圆线虫感染，尤其是如果存在血液嗜酸性粒细胞增多的情况。由于目前抗寄生虫治疗的效果尚未得到证实，必须向生活在暴露地区的人们提供信息，以限制这种疾病的发病率。
