Spinal sensory radiculopathy due to Angiostrongylus cantonensis infection.
A case of A. cantonensis infection which appears to have originated in Fiji where the disease has not previously been reported, is described. A 45-year-old Caucasian male from Australia, was admitted for investigation of an 8-week history of paraesthesia and numbness affecting his right leg. The patient was a contract driller who had been working on Viti Levu Island, Fiji, at the time of onset of his illness. He had spent most of the preceding 25 years in the South East Asian and Pacific regions where his diet regularly included salads and other uncooked vegetables. Computed tomographic myelography and magnetic resonance imaging of the spinal cord revealed A. cantonensis infection. No therapy was given and the symptoms had resolved 2 months later.<new para>ADDITIONAL ABSTRACT:<new para>The most common cause of eosinophilic meningitis is the rat lung worm Angiostrongylus cantonensis, a parasite which is endemic in the South East Asian and Pacific regions. While the typical clinical presentation is that of meningitis associated with an eosinophilic pleocytosis, a 45 year old man presented with a radiculomyelopathy, associated with an eosinophilic pleocytosis and cerebrospinal fluid antibodies to A. cantonensis but without signs or symptoms of meningitis. A worm was demonstrated on both computed tomographic myelography and magnetic resonance imaging scan of the spinal cord.newline˜AS