Epidemiology
The patient had worked for two years in a seafood restaurant as a cooker. He liked to eat raw seafood and before becoming ill he frequently ate snail.
Physical examination
The patient had no defect in speech. Binoptic papillas showed clear boundaries. The eye movement was normal in all directions. There was no nystagmus. The patient had no signs of meningeal irritation and no cranial nerve damage. Muscle strength, tonus and sensation were normal. The jerk reflexes of his limbs were symmetrical and pathological reflex was negative.
Auxiliary examination
Multiple lumbar punctures revealed that eosinophil levels were higher than the normal range (up to 34%; see Figure 1), consistent with eosinophilic inflammation. Hematological testing revealed increasing numbers of eosinophils (Table 1). Liver and renal functions were normal. Erythrocyte sedimentation rate was also within the normal range. The patient was negative for the human immunodeficiency virus, syphilis, cysticercosis and stool examination. A head computed tomography (CT) scan did not show any evidence of abnormality. The CSF was negative for acid-fast staining and Indian-ink staining, and did not carry cysticercus or herpes simplex virus antibodies.
Treatments
Since the patient had intracranial hypertension, we treated him by cerebral dehydration to reduce intracranial pressure. He was also treated with 10 mg/d of dexamethasone (a synthetic glucocorticoid hormone) and fluid infusion. Afterward the number of eosinophils was reduced, shown by hematological testing and examinations of CSF (Table 1). The amount of dexamethasone was gradually decreased. The patient felt better and had no headache, dizziness or fever. He was dismissed from our hospital after 15 days when he was back to normal status.
EpidemiologyThe patient had worked for two years in a seafood restaurant as a cooker. He liked to eat raw seafood and before becoming ill he frequently ate snail.Physical examinationThe patient had no defect in speech. Binoptic papillas showed clear boundaries. The eye movement was normal in all directions. There was no nystagmus. The patient had no signs of meningeal irritation and no cranial nerve damage. Muscle strength, tonus and sensation were normal. The jerk reflexes of his limbs were symmetrical and pathological reflex was negative.Auxiliary examinationMultiple lumbar punctures revealed that eosinophil levels were higher than the normal range (up to 34%; see Figure 1), consistent with eosinophilic inflammation. Hematological testing revealed increasing numbers of eosinophils (Table 1). Liver and renal functions were normal. Erythrocyte sedimentation rate was also within the normal range. The patient was negative for the human immunodeficiency virus, syphilis, cysticercosis and stool examination. A head computed tomography (CT) scan did not show any evidence of abnormality. The CSF was negative for acid-fast staining and Indian-ink staining, and did not carry cysticercus or herpes simplex virus antibodies.TreatmentsSince the patient had intracranial hypertension, we treated him by cerebral dehydration to reduce intracranial pressure. He was also treated with 10 mg/d of dexamethasone (a synthetic glucocorticoid hormone) and fluid infusion. Afterward the number of eosinophils was reduced, shown by hematological testing and examinations of CSF (Table 1). The amount of dexamethasone was gradually decreased. The patient felt better and had no headache, dizziness or fever. He was dismissed from our hospital after 15 days when he was back to normal status.
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Epidemiology
The patient had worked for two years in a seafood restaurant as a cooker. He liked to eat raw seafood and before becoming ill he frequently ate snail.
Physical examination
The patient had no defect in speech. Binoptic papillas showed clear boundaries. The eye movement was normal in all directions. There was no nystagmus. The patient had no signs of meningeal irritation and no cranial nerve damage. Muscle strength, tonus and sensation were normal. The jerk reflexes of his limbs were symmetrical and pathological reflex was negative.
Auxiliary examination
Multiple lumbar punctures revealed that eosinophil levels were higher than the normal range (up to 34%; see Figure 1), consistent with eosinophilic inflammation. Hematological testing revealed increasing numbers of eosinophils (Table 1). Liver and renal functions were normal. Erythrocyte sedimentation rate was also within the normal range. The patient was negative for the human immunodeficiency virus, syphilis, cysticercosis and stool examination. A head computed tomography (CT) scan did not show any evidence of abnormality. The CSF was negative for acid-fast staining and Indian-ink staining, and did not carry cysticercus or herpes simplex virus antibodies.
Treatments
Since the patient had intracranial hypertension, we treated him by cerebral dehydration to reduce intracranial pressure. He was also treated with 10 mg/d of dexamethasone (a synthetic glucocorticoid hormone) and fluid infusion. Afterward the number of eosinophils was reduced, shown by hematological testing and examinations of CSF (Table 1). The amount of dexamethasone was gradually decreased. The patient felt better and had no headache, dizziness or fever. He was dismissed from our hospital after 15 days when he was back to normal status.
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