Eosinophilic meningitis in Sisaket Hospital between 2001-2004 ; 2 cases report

Abstract

Objective: 1. To study the incidence rate, clinical feature, laboratory investigation and treatment of eosinophilic meningitis patients in Sisaket hospital between 2001-2004
                  2. Report 2 cases of children patients.
Study design: Descriptive, retrospective study
Patients and method: All patients diagnosed with eosinophilic meningitis in Sisaket hospital between 2001 - 2004 were reviewed about clinical feature, laboratory investigation and treatment. Two cases of children patients were reported.
Result: There were 21 patients 12 men,9 women two children. The numbers of patient in 2001-2004 were 12,2,4 and 3. The age raned between 20 months to 66 years. Most of patients were living outside of Amphur Mueng Sisaket (17 pts.) The occupation were farmers (12 pts.) labours (4 pts.) and students (5 pts.) There were 4 patients had past history of ingestion of raw snails. The clinical manifestation were fever (4 pts/19.05%), severe headache (16 pts/76.19%), alteration of conscious (5 pts/23.81%), convulsion (3 pts/14.29%), stiff neck (11 pts/52.38%), paraplegia (2 pts/9.52%), and cranial nerve involvement ; diplopia, lateral rectus palsy of eye (3 pts/14.29%). Laboratory investigation included CBC and CSF analysis. Most of patients had blood eosinophilia (61.11%) and CSF eosinophilia (88.89%), CSF protein mean 144.61 mg% CSF sugar mean 45.78 mg%. CSF cell count mean 1,059 cell/cumm. One case had tested for Angiostrongylus cantonensis antibody from CSF, and the result was negative. The treatment were supportive & symptomatic, lumbar puncture, and corticosteroid accompany with anthelmintic drugs. Most of pateints were full recovery, except one patient death.
Conclusion: There were some patients with eosinophilic meningitis in Sisaket hospital. The cause of eosinophilic meningitis could not be identified but the assumption of parasitic infection; related to contaminated of parasitic larva in food. Then the campaige for clean food should be useful and decreased this disease.