Next-generation sequencing specifies Angiostrongylus eosinophilic meningoencephalitis in infants: Two case reports. Issue 35 (August 2019)

• Record Type: Journal Article
• Authors: Xie, Mei; Zhou, Zhen; Guo, Suhua; Li, Zengqing; Zhao, Hui; Deng, Jiusheng
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 98:Issue 35(2019)
• Publication Date: 2019-08
• Subjects: Angiostrongylus cantonensis -- diagnosis -- eosinophilic meningoencephalitis -- infants -- next-generation sequencing; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000016985
• Languages: English
• ISSNs: 0025-7974

Abstract

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.