J Med Assoc Thai 2019; 102 (4):82

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How to Differentiate Angiostrongylus cantonensis and Gnathostoma spinigerum as a cause of Eosinophilic Meningitis?
Meesing A Mail, Peerabool C , Pitaknoppakul A , Thimachai P , Tiamkao S , Chotmongkol V , Sawanyawisuth K

Objective: The common causes of eosinophilic meningitis are Angiostrongylus cantonensis and Gnathostoma spinigerum. To
differentiate both parasites can be performed by serology test. This study aimed to use clinical factors to differentiate cause of eosinophilic meningitis from A. cantonensis or G. spinigerum.
Materials and Methods: The authors retrospectively reviewed clinical factors of eosinophilic meningitis patients who were tested for A. cantonensis and G. spinigerum serology test at Srinagarind Hospital, Khon Kaen University, Thailand. Clinical factors were compared by descriptive statistics.
Results: There were 33 eosinophilic meningitis patients who were tested for both parasites by serology tests. Of those, 22 patients were positive for A. cantonensis, while 11 patients were positive for G. spinigerum. Patients with A. cantonensis had more headache and fever, while patients with G. spinigerum had more migratory swelling, radicular pain, and abnormal Babinski’s sign. Regarding laboratory tests, peripheral eosinophilia, numbers of white blood cells in the cerebrospinal fluid, and numbers of eosinophils in the
cerebrospinal fluid were not different between eosinophilic meningitis patients from A. cantonensis and G. spinigerum.
Conclusion: Clinical factors may be used to differentiate both parasites as a cause of eosinophilic meningitis.

Keywords: Eosinophilia, Migratory swelling, Radicular pain


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