Eosinophilic myelomeningoencephalitis caused by Angiostrongylus cantonensis: a report of three cases.

Three members of a family developed eosinophilic myelomeningoencephalitis following ingestion of Pila snails. They were father, daughter and son and had similar clinical presentations. Two days after ingestion of snails, they developed a generalized itchy maculopapular rash followed by myalgia, marked paresthesia, fever and headache. Two days later there was weakness of the extremities which was progressive in severity involving the legs more than the arms. They later developed urine retention and cloudiness of consciousness. Two patients progressed to coma, one of whom died after 3 weeks and the other died at home 9 months after the onset. Autopsy of the fatal case revealed multiple tracks and cavities with the presence of Angiostrongylus cantonensis in the brain and various levels of the spinal cord.

Primary amoebic meningoencephalitis in Thailand: report of a case and review literatures.

Primary amoebic meningoencephalitis (PAM) which is caused by free-living amoeba, Naegleria fowleri, is a rare disease. We report the fifth case in Thailand in order to add more information. The patient was a previously healthy 4 1/2-year-old girl from Nakhon Pathom province. For several weeks before this illness she had swum in a water supply canal. She developed high fever with change in consciousness. Her cerebrospinal fluid contained numerous Naegleria fowleri which grew in culture media and mice inoculation. She did not respond to treatment with intravenous and intraventricular amphotericin B, and oral rifampicin. She died on the fifth day of illness. Water sample from the canal also grew N. fowleri. All five reported cases in Thailand were reviewed. It was found that none of them had been exposed to a common source. Four of the five cases were male, and four cases occurred during the summer months, March to May. These findings agree with worldwide information.