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广州管圆线虫所致嗜酸性粒细胞性脑膜炎

[Eosinophilic meningitis due to Angiostrongylus cantonensis].

作者信息

Legrand G, Angibaud G

机构信息

Dispensaire de Voh, Nouvelle-Calédonie.

出版信息

Rev Neurol (Paris). 1998 Apr;154(3):236-42.

PMID:9773048
Abstract

Angiostrongylus cantonensis is the most common etiological agent of eosinophilic meningitis. Adults are harbored in the pulmonary arteries of rats. Larvae develop within various natural (mollusks) and paratenic (snails...) hosts. After ingestion, larvae reach the human central nervous system where they cannot complete their life cycle. This zoonosis is usually seen in Southeast Asia and South Pacific islands. Nevertheless, a few imported cases have been reported in Western countries, possible because of the incubation delay. Mild meningeal irritation signs, paresthesia, cranial nerve abnormalities (i.e: II, III, VI, VII) are the most usual by encountered signs. Severe cases with brain involvement have been reported. In endemic areas, typical clinical signs associated with C.S.F. eosinophilic pleocytosis allow the diagnosis but Elisa test may be useful. Prognosis is always excellent even if headache and malaise may last a few weeks. No antihelminthic agent is efficient against Angiostrongylus cantonensis. Prophylaxia by public health counselling program is fruitful.

摘要

广州管圆线虫是嗜酸性粒细胞性脑膜炎最常见的病原体。成虫寄生于大鼠的肺动脉。幼虫在各种天然宿主(软体动物)和转续宿主(蜗牛等)体内发育。被摄入后,幼虫到达人类中枢神经系统,但在那里它们无法完成生命周期。这种人畜共患病通常见于东南亚和南太平洋岛屿。然而,西方国家也报告了一些输入性病例,可能是因为潜伏期较长。轻度脑膜刺激征、感觉异常、脑神经异常(如:II、III、VI、VII)是最常见的体征。也有报道出现累及脑部的严重病例。在流行地区,脑脊液嗜酸性粒细胞增多相关的典型临床体征有助于诊断,但酶联免疫吸附测定(ELISA)试验可能也有用。即使头痛和不适可能持续数周,预后通常也很好。没有抗蠕虫药物对广州管圆线虫有效。通过公共卫生咨询计划进行预防是有成效的。

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