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Review
, 22 (2), 322-48, Table of Contents

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

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Review

Update on Eosinophilic Meningoencephalitis and Its Clinical Relevance

Carlos Graeff-Teixeira et al. Clin Microbiol Rev.

Abstract

Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in fluids and tissues is rarely possible, while images and clinical examinations do not lead to a definitive diagnosis. Treatment usually requires the concomitant administration of corticoids and anthelminthic drugs, yet new compounds and their extensive and detailed clinical evaluation are much needed. Eosinophilia in fluids may be detected in other infectious and noninfectious conditions, such as neoplastic disease, drug use, and prosthesis reactions. Thus, distinctive identification of eosinophils in fluids is a necessary component in the etiologic diagnosis of CNS infections.

Figures

FIG. 1.
FIG. 1.
Female A. cantonensis worms are 22 to 34 mm long and show a dark red digestive organ, two white reproductive organs, and a transparent cuticle. (Courtesy of Juliano Romanzini, Grupo de Parasitologia Biomédica da PUCRS, Porto Alegre, Brazil; reproduced with permission.)
FIG. 2.
FIG. 2.
Young A. cantonensis worms in brain tissue next to the meninges of experimentally infected R. norvergicus. (Courtesy of Camila Krug, Grupo de Parasitologia Biomédica da PUCRS, Porto Alegre, Brazil; reproduced with permission.)
FIG. 3.
FIG. 3.
Enlargement (arrow) of the conus medularis with micronodulations in spinal cord schistosomiasis. (Reproduced from reference with permission of the publisher.)
FIG. 4.
FIG. 4.
S. mansoni egg in the spinal cord of a patient with myeloradiculopathy. The eggs have a lateral spine and are large structures (114 to 180 μm long by 45 to 70 μm wide). (Reprinted from reference with permission of the publisher.)

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