Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (11): 827-.doi: 10.3969/j.issn.1000-3606.2019.11.008

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Clinical analysis of 9 cases of parasitic encephalopathy in children

CHEN Lianfeng, CHEN Wenxiong, LI Xiaojing, GAO Yuanyuan, PENG Bingwei, YANG Sida   

  1. Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou 510623, Guangdong, China
  • Online:2019-11-15 Published:2020-02-03

Abstract:  Objective To investigate clinical characteristics of parasitic encephalopathy in children. Methods A retrospective study was carried out to analyze the clinical data of 9 cases of parasitic encephalopathy from December 2014 to December 2018. Results There were 6 males and 3 females suffered from parasitic encephalopathy. The average age was (2.81±1.53) years. 5 cases with epidemiological exposure history were identified. Main clinical manifestations included: fever (8), mental fatigue (7), vomiting (5), headache (2), convulsion (2), paralysis of the left leg (1), ataxia (1), confusion of consciousness with abnormal mental behavior (1), and hyperalgesia of the right upper limb (1). Routine test and biochemistry indicators of cerebrospinal fluid were abnormal in 8 cases, accompanied with increased eosinophil counting in 5 cases. Peripheral blood eosinophil increased in 8 cases. Specific antibodies in serum and cerebrospinal fluid were both positive in 5 cases. Angiostrongylus cantonensis in 2 cases was detected by Next-Generation Sequencing of cerebrospinal fluid. Magnetic resonance imaging showed leptomeningeal enhancement in 2 cases, and abnormal signals in brain parenchyma in 4 cases. 7 cases were confirmed as parasitic encephalopathy: Angiostrongyliasis cantonensis (5), cerebral toxoplasmosis (5), cerebral sparganosis (1), and 2 suspected cases. 7 cases were treated with albendazole, 1 with SMZco followed by acetylspiramycin, and 1 treated with surgery. Finally, 7 cases were cured and had no sequela,1 left a limp of the left leg, and 1 failed to follow up. Conclusion If children had intracranial infectious diseases accompanied with peripheral blood eosinophils increasing, parasitic encephalopathy should be considered, especially Angiostrongyliasis cantonensis in Guangdong.

Key words: parasitic encephalopathy; eosinophil; child