Diagnosis of human angiostrongyliasis in a case of hydrocephalus using next-generation sequencing: a case report and literature review

BMC Neurol. 2024 Aug 12;24(1):281. doi: 10.1186/s12883-024-03663-7.

Abstract

Background: Angiostrongyliasis cantonensis is a severe yet rare parasitic infection caused by the larvae of Angiostrongylus cantonensis. The primary characteristic feature of this foodborne illness in humans is eosinophilic meningitis. Recently, there has been a gradual increase in reported cases globally. Due to the lack of typical clinical symptoms, signs, and specific laboratory tests, early diagnosis of this disease poses significant challenges. Failure to diagnose and treat this condition promptly can result in fatalities.

Methods: We present the case of a 13-year-old male patient who initially presented with fever and headache. The patient was preliminarily diagnosed with bacterial meningitis and received treatment with antibacterial drugs. However, the patient's condition worsened, and he developed progressive consciousness disturbances. Eventually, metagenomic next-generation sequencing (mNGS) testing of cerebrospinal fluid samples indicated Angiostrongylus cantonensis infection. Following treatment with albendazole and prednisone, the patient made a full recovery. We include this case report as part of a literature review to emphasize the potential applications of mNGS in the early diagnosis of Angiostrongyliasis cantonensis.

Conclusion: mNGS technology plays a crucial role in the diagnosis of angiostrongyliasis cantonensis. As this technology continues to evolve and be applied, we believe it will play an increasingly important role in diagnosing, treating, and monitoring angiostrongyliasis cantonensis.

Keywords: Angiostrongylus cantonensis; Diagnosis; Eosinophilic meningitis; Metagenomic next-generation sequencing.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Angiostrongylus cantonensis* / genetics
  • Angiostrongylus cantonensis* / isolation & purification
  • Animals
  • High-Throughput Nucleotide Sequencing* / methods
  • Humans
  • Hydrocephalus* / diagnosis
  • Hydrocephalus* / parasitology
  • Male
  • Strongylida Infections* / complications
  • Strongylida Infections* / diagnosis
  • Strongylida Infections* / drug therapy

Supplementary concepts

  • Angiostrongyliasis