Zhao JH, Li WJ, Jiao J, Wang MX, Zhang XM, Yin JY, Hu WZ, Song Q, Liu J. Treatment of a rare and severe infection of central nervous system by Angiostrongylus cantonensis: A case report. World J Radiol 2025; 17(2): 105059 [PMID: 40060957 DOI: 10.4329/wjr.v17.i2.105059]
Corresponding Author of This Article
Jie Liu, PhD, Director, Department of Critical Care Medicine, Hainan Hospital of Chinese PLA General Hospital, No. 80 Jianglin Road, Haitang District, Sanya 572013, Hainan Province, China. liujie20231974@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Feb 28, 2025; 17(2): 105059 Published online Feb 28, 2025. doi: 10.4329/wjr.v17.i2.105059
Treatment of a rare and severe infection of central nervous system by Angiostrongylus cantonensis: A case report
Jian-Hui Zhao, Wen-Ju Li, Jie Jiao, Ming-Xing Wang, Xi-Mu Zhang, Jian-Yuan Yin, Wen-Zhi Hu, Qing Song, Jie Liu
Jian-Hui Zhao, Jie Jiao, Xi-Mu Zhang, Jian-Yuan Yin, Qing Song, Jie Liu, Department of Critical Care Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya 572013, Hainan Province, China
Wen-Ju Li, Department of Tropical Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya 572013, Hainan Province, China
Ming-Xing Wang, Department of Disease Control and Prevention, 96602 Hospital of Chinese People’s Liberation Army, Kunming 650233, Yunnan Province, China
Wen-Zhi Hu, Department of Burn and Plastic Surgery, Air Characteristic Medical Center affiliated to PLA Air Force Military Medical University, Beijing 100142, China
Co-first authors: Jian-Hui Zhao and Wen-Ju Li.
Co-corresponding authors: Qing Song and Jie Liu.
Author contributions: Zhao JH and Li WJ were equally involved in the conceptualization of the study, treatment of the patient, and the writing of the manuscript; Jiao J, Wang MX, Zhang XM, Yin JY and Hu WZ contributed to patient treatment, data collection; Liu J and Song Q were equally involved in the supervision of the study, administration, consultation, and revising the manuscript; Liu J managed journal correspondence; All the authors read and approved the final version of the manuscript to be published.
Supported by the Hainan Provincial Natural Science Foundation of China, No. 824MS173 and No. 823MS165; and the Project of Hainan Province Clinical Medical Center.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Liu, PhD, Director, Department of Critical Care Medicine, Hainan Hospital of Chinese PLA General Hospital, No. 80 Jianglin Road, Haitang District, Sanya 572013, Hainan Province, China. liujie20231974@163.com
Received: January 10, 2025 Revised: January 26, 2025 Accepted: February 14, 2025 Published online: February 28, 2025 Processing time: 47 Days and 17.9 Hours
Abstract
BACKGROUND
Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice. Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.
CASE SUMMARY
A 20-year-old male developed persistent neck and back pain after consuming raw snail meat, followed by urinary retention and low fever. After admission, the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system. After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing, albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously. With effective antiparasitic treatment, the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.
CONCLUSION
This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.
Core Tip: A 20-year-old male developed persistent neck and back pain, urinary retention, and low fever after consuming raw snail meat. Initially misdiagnosed with viral infection and Mycobacterium tuberculosis in the central nervous system, the patient was later confirmed to have Angiostrongylus cantonensis infection via metagenomics next-generation sequencing. Effective antiparasitic treatment with albendazole, ceftriaxone, and methylprednisolone led to successful weaning from mechanical ventilation and transfer out of the intensive care unit for hyperbaric oxygen and rehabilitation treatment. This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.
