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Cited by 81Mollusks and Parasites StudiesParasitic infections in humans and animalsParasites and Host Interactions

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Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe

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Federspiel, Frederik, Skovmand, Sofie, Skarphedinsson, Sigurdur·2020·International Journal of Infectious Diseases
DOI 10.1016/j.ijid.2020.01.012
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Abstract

OBJECTIVES: To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe. METHODS: A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data. RESULTS: Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended. CONCLUSIONS: We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated.

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Metadata

Authors
Federspiel, F., Skovmand, S., & Skarphedinsson, S.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • Odense University Hospital (DK)
Corresponding author
  • Federspiel, Frederik
  • Skovmand, Sofie
ORCID
Venue
International Journal of Infectious Diseases
Publisher
Elsevier BV
Published
2020-04
Volume
93
Pages
28-39
ISSN
1201-9712 (ISSN-L)
DOI
10.1016/j.ijid.2020.01.012
OpenAlex
W3002195335
Cited by
81
References
0
Citations by year
2026: 8 · 2025: 16 · 2024: 17 · 2023: 9 · 2022: 14 · 2021: 9 · 2020: 8
FWCI
1.05
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Infectious Diseases (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc-nd)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Mollusks and Parasites Studies
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasitic infections in humans and animals
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
Keywords
eosinophilic meningitis, Angiostrongylus cantonensis, angiostrongyliasis, imported parasitic infection, headache, cerebrospinal fluid eosinophilia, eosinophilia, cerebrospinal fluid protein, albendazole, mebendazole, anthelmintic treatment, clinical features
MeSH terms
Adolescent, Adult, Animals, Asia, Southeastern, Australia, Eosinophilia, Europe, Female, Humans, Infant, Male, Meningitis, Middle Aged, Polynesia, Snails, West Indies, Angiostrongylus cantonensis, Strongylida Infections, Seafood

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CoChat. (2026). Citation check: Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. https://app.cochat.ai/papers/10.1016/j.ijid.2020.01.012
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Federspiel, F., Skovmand, S., & Skarphedinsson, S. (2020). Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. International Journal of Infectious Diseases. https://doi.org/10.1016/j.ijid.2020.01.012