Next-generation Sequencing Specifies Angiostrongylus Eosinophilic Meningoencephalitis in Infants: Two Case Reports

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2019 Aug 30

PMID 31464947

Citations 12

Authors

Mei Xie

Zhen Zhou

Suhua Guo

Zengqing Li

Hui Zhao

Jiusheng Deng

Affiliations

Soon will be listed here.

Abstract

Rationale: Angiostrongylus cantonensis-induced eosinophilic meningoencephalitis (AEM) in infants is a very rare but fatal disease. Utilization of genetic assay to detect the cerebral parasite plays an important role for the treatment of the infection.

Patient Concerns: Two infants (<2 years) presented with cough, intermittent fever, mental fatigue, and poor diet.

Diagnosis: The patients were under clinical examination and laboratory test including cardiac ultrasound, chest X-ray, blood or cerebrospinal fluid (CSF) cell counting, serum enzyme-linked immunosorbent assay (ELISA), head magnetic resonance imaging (MRI) and next-generation sequencing (NGS) on DNA from CSF. Due to hypereosinophils in patients' peripheral blood and CSF, and abundant DNA sequences from A cantonensis in CSF, the patients were diagnosed with Angiostrongylus eosinophilic meningoencephalitis.

Interventions: The patients were treated with albendazole to deworm, and methylprednisolone to reduce inflammation.

Outcome: The patients were completely recovered from AEM without relapse after 10-day treatment.

Lessons: ELISA and MRI are not sufficiently accurate for the diagnosis of AEM in infants. NGS can specify the infection by the cerebral parasite and offers a new effective approach for the early and precise diagnosis of AEM in infants.

Citing Articles

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The application of metagenomic next-generation sequencing for eosinophilic meningitis in a pediatric patient: A case report.

Liu J, Tao J, Chen W, Wang T, Chen X, Shen M Front Public Health. 2022; 10:1003013.

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