Eosinophilic Meningitis: A Suspected Case of Angiostrongylosis Found in Shizuoka Prefecture, Honshu, Japan

Abstract

A patient with eosinophilic meningit is in Shizuoka Prefecture, Honshu, Japan had nausea, vomiting and headache on admission; laboratory examinations revealed leukocytosis with eosinophilia. Eight days later neck stiffness appeared. Lumbar puncture showed an increase of the initial pressure in association with eosinophilic pleocytosis in the spinal fluid. The possibility of angiostrongylosis was considered because the patient had eaten raw slugs for 4 years as a remedy for lumbago. Although the serum contained cross-reactive antibodies against Toxocara canis, positive reactions to Angiostrongylus cantonensis antigens were observed in all of the immunological tests made. These observations, together with results of epidemiological studies in Honshu carried out by other investigators, suggest that the present case of eosinophilic meningitis may have been caused by A. cantonensis. One previous case has been reported from Honshu Island, Japan.