兒童嗜伊紅性腦膜炎和腦膜腦炎

Eosinophilic Meningitis and Meningoencephalitis in Children

黃高彬(Kao-Pin Hwang) ； 陳榮霖(Eng-Rin Chen) ； 陳添享(Tien-Siang Chen)

《Acta Paediatrica Sinica》 35卷2期 (1994/04) Pp. 124-135

https://doi.org/10.7097/APS.199404.0124

摘要

87例臨床被診斷爲嗜伊紅性腦膜炎或腦膜腦炎的小兒科病人就其臨床特性分析研究。87位病童中男性38人(43.7%)，女性49(56.3%)，男女之間並無顯著的差異。70位(80.5%)病童年齡小於九歲，好發的月份是五月到十月之間，77位(88.5%)病人有接觸、玩或吃非洲大蝸牛、蛞蝓或福壽螺的過去史。本研究發現小兒嗜伊紅性腦膜炎或腦膜腦炎其潛伏期較短，平均爲13.0天。臨床症狀以發燒(92.0%)爲最常見，其次是嘔吐(72.4%)，約有一半(50.6%)的病例有腹脹的現象。眼底檢查，視乳頭水腫的病例佔23.0%，明顯的多於泰國成人病例(12%)的報告。末稍血液白血球數大於10.000/mm^3和嗜伊紅性白血球的百分比大於10%的病例分別佔83.9%和85.1%，高於泰國報告的56%和73%。合併第六和第七腦神經病變的病例多達17.2%和11.5%。腰椎穿刺腦脊髓液中的蟲體發現率爲43.7%，達高於其他的報告；最近以改良的新法，蟲體發現率更提高到50%以上。

並列摘要

Eosinophilic meningitis or meningoencephalitis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characterisrtics among 87 children in Taiwan were performed. Thirty-eight (43.7%) were male and 49 (56.3%) females, and 88.5% could be traced to a history of contact with the intermediate host, the giant African snail, Achatinafulica, which plays a major role in transmission. The incubation period (average: 13.0 days) was shorter in children than in adults (average: 16.5 days) Near thirty percent (28.7%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (92.0%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 17.2% and 11.5% respectively. Ophthalmologic fundoscopy showed that 23.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 83.9% and 85.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 87 cases was 43.7%; 141 worms were collected from one female patient using a pumping method. In the recent 3 years, levamisole was used clinically with good result.

並列關鍵字

eosinophilic meningitis ； meningoencephalitis ； angiostrongyliasis cantonensis