RESUMO
OBJECTIVE: To report a schistosomal myeloradiculopathy case in a non-endemic area. CASE DESCRIPTION: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient's cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. COMMENTS: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract's disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.
Assuntos
Neuroesquistossomose/diagnóstico , Neuroesquistossomose/parasitologia , Schistosoma mansoni/isolamento & purificação , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêutico , Brasil/epidemiologia , Criança , Quimioterapia Combinada , Eosinofilia/líquido cefalorraquidiano , Humanos , Masculino , Meningite/imunologia , Neuroesquistossomose/tratamento farmacológico , Neuroesquistossomose/reabilitação , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Schistosoma mansoni/imunologia , Esteroides/administração & dosagem , Esteroides/uso terapêutico , Resultado do TratamentoRESUMO
ABSTRACT Objective: To report a schistosomal myeloradiculopathy case in a non-endemic area. Case description: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient's cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. Comments: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract's disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.
RESUMO Objetivo: Relatar um caso de mielorradiculopatia esquistossomótica em área não endêmica. Descrição do caso: Paciente do sexo masculino, 11 anos, previamente hígido, com história aguda de paresia de membros inferiores, que evoluiu para membros superiores e tronco, associada à alteração de sensibilidade e formação de globo vesical. O exame do líquor demonstrava meningite eosinofílica, além de eosinofilia periférica. A investigação resultou em sorologia positiva para Schistosoma mansoni. O tratamento foi realizado com corticoterapia e praziquantel 60 mg/kg, com nova dose após um mês, além de fisioterapia para reabilitação. Evoluiu com melhora clínica no exame neurológico, com nível de secção medular que inicialmente correspondia a C6, encontrando-se atualmente em T6. Mantém uso de prednisolona 30 mg/dia e dependência de sonda vesical de demora. Comentários: A esquistossomose é uma doença endêmica em muitas regiões do Brasil, porém com pouca incidência no Sul do país. Dentre as principais manifestações, a mielorradiculopatia esquistossomótica é a forma ectópica mais grave e deve ser suspeitada na vigência de dor lombar, alteração de força e/ ou sensibilidade de membros inferiores e distúrbio urinário. O diagnóstico e o tratamento devem ser instituídos precocemente para diminuir o risco de sequelas neurológicas graves. O tratamento pode ser realizado com esquistossomicidas, corticosteroides e/ ou cirurgia.
Assuntos
Schistosoma mansoni/isolamento & purificação , Neuroesquistossomose/diagnóstico , Neuroesquistossomose/parasitologia , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Schistosoma mansoni/imunologia , Esteroides/administração & dosagem , Esteroides/uso terapêutico , Brasil/epidemiologia , Resultado do Tratamento , Neuroesquistossomose/tratamento farmacológico , Neuroesquistossomose/reabilitação , Quimioterapia Combinada , Eosinofilia/líquido cefalorraquidiano , Meningite/imunologia , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêuticoRESUMO
Angiostrongylus cantonensis is a zoonotic pathogen that occasionally causes human angiostrongyliasis; its main clinical manifestation is eosinophilic meningitis. This report defines the concept of intrathecal activation of complement as evidence of intrathecal synthesis of major immunoglobulins during this disease. Details are presented of the activation of complement system components in cerebrospinal fluid, and their application to our understanding of this tropical disease, which is emerging in the Western hemisphere. Intrathecal synthesis of at least one of the major immunoglobulins and a wide spectrum of patterns may be observed. Although intrathecal synthesis of C3c is always present, C4 intrathecal synthesis does not occur in every patient. The diversity of intrathecal synthesis and activation of the different complement pathways enables their division into three variant groups (A, B, and C). Variant group A includes the classical and/or lectin pathway and involves two or more major immunoglobulins with C3 and C4 intrathecal synthesis. Variant group B involves C4 in cerebrospinal fluid that comes from blood in the intrathecal activation of the classical pathway. Variant group C includes the alternative pathway.
Assuntos
Sistema Nervoso Central/imunologia , Sistema Nervoso Central/parasitologia , Infecções por Strongylida/imunologia , Angiostrongylus cantonensis/isolamento & purificação , Angiostrongylus cantonensis/patogenicidade , Animais , Complemento C3c/líquido cefalorraquidiano , Complemento C3c/imunologia , Complemento C4b/líquido cefalorraquidiano , Complemento C4b/imunologia , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/imunologia , Eosinofilia/parasitologia , Humanos , Imunoglobulinas/líquido cefalorraquidiano , Imunoglobulinas/imunologia , Meningite/líquido cefalorraquidiano , Meningite/imunologia , Meningite/parasitologia , Fragmentos de Peptídeos/líquido cefalorraquidiano , Fragmentos de Peptídeos/imunologia , Infecções por Strongylida/líquido cefalorraquidiano , Infecções por Strongylida/parasitologiaRESUMO
Cerebrospinal fluid (CSF) samples from clinically diagnosed patients with detectable Angiostrongylus cantonensis-specific antibodies (n = 10), patients with clinically suspected cases that tested negative for A. cantonensis-antibodies (n = 5) and patients with cerebral gnathostomiasis (n = 2) and neurocysticercosis (n = 2) were examined by a single-step polymerase chain reaction (PCR) method using the AC primers for the 66-kDa native protein gene. The PCR method detected A. cantonensis DNA in CSF samples from four of 10 serologically confirmed angiostrongyliasis cases. The PCR results were negative for the remaining CSF samples. The nucleotide sequences of three positive CSF-PCR samples shared 98.8-99.2% similarity with the reference sequence of A. cantonensis. These results indicate the potential application of this PCR assay with clinical CSF samples for additional support in the confirmation of eosinophilic meningitis due to A. cantonensis.
Assuntos
Angiostrongylus cantonensis/genética , Eosinofilia/diagnóstico , Meningite/diagnóstico , Infecções por Strongylida/diagnóstico , Angiostrongylus cantonensis/isolamento & purificação , Animais , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/parasitologia , Humanos , Meningite/líquido cefalorraquidiano , Meningite/parasitologia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Infecções por Strongylida/líquido cefalorraquidianoRESUMO
Cerebrospinal fluid (CSF) samples from clinically diagnosed patients with detectable Angiostrongylus canto-nensis-specific antibodies (n = 10), patients with clinically suspected cases that tested negative for A. cantonensis-an-tibodies (n = 5) and patients with cerebral gnathostomiasis (n = 2) and neurocysticercosis (n = 2) were examined by a single-step polymerase chain reaction (PCR) method using the AC primers for the 66-kDa native protein gene. The PCR method detected A. cantonensis DNA in CSF samples from four of 10 serologically confirmed angiostrongyliasis cases. The PCR results were negative for the remaining CSF samples. The nucleotide sequences of three positive CSF-PCR samples shared 98.8-99.2% similarity with the reference sequence of A. cantonensis. These results indicate the potential application of this PCR assay with clinical CSF samples for additional support in the confirmation of eosinophilic meningitis due to A. cantonensis.
Assuntos
Animais , Humanos , Angiostrongylus cantonensis/genética , Eosinofilia/diagnóstico , Meningite/diagnóstico , Infecções por Strongylida/diagnóstico , Angiostrongylus cantonensis/isolamento & purificação , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/parasitologia , Meningite/líquido cefalorraquidiano , Meningite/parasitologia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Infecções por Strongylida/líquido cefalorraquidianoRESUMO
CSF eosinophilia (CSF-eo) is uncommon and is usually caused by helminthic infections. However, it has also been found in â¼30% of patients experiencing intraventricular shunt malfunctions. We present a case report and review the conditions associated with CSF-eo and their prophylaxis. An 8 year-old boy with tetraventricular hydrocephalus has had several shunt malfunctions over the last three years. During hospitalization in January 2009 for shunt revision, a transient 30% eosinophilia was detected in his cerebral spinal fluid (CSF) concomitant with Staphylococcus epidermidis infection and long term vancomycin administration. After several shunt replacements and antibiotic treatment, CSF-eo eventually disappeared with good overall clinical response. CSF-eo is a transient and focal event mainly associated with infection, reactions to foreign substances, particles or blood, or obstruction of tubing by normal or fibro-granulomatous tissues. Infection associated with CSF-eo is usually caused by S. epidermidis and Propioniumbacterium acnes. In addition to infection, allergy to silicone and other foreign materials may also be a cause of CSF-eo. We review the diversity of conditions and proposed mechanisms associated with CSF-eo, as well as recommendations for the care of patients with shunts. Detection of CSF-eo has been shown to be a useful indicator of shunt malfunction. As such, it provides physicians with an indicator of a hypersensitivity reaction that is underway or the need to identify bacterial infection. We also highlight the need for improved biocompatibility of shunt hardware and describe strategies to avoid conditions leading to shunt malfunction.
Assuntos
Derivações do Líquido Cefalorraquidiano/efeitos adversos , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/etiologia , Antibacterianos/uso terapêutico , Criança , Hipersensibilidade a Drogas , Eosinofilia/terapia , Falha de Equipamento , Humanos , Hidrocefalia/cirurgia , Masculino , Silicones/efeitos adversos , Infecções Estafilocócicas/complicações , Staphylococcus epidermidis , Derivação Ventriculoperitoneal/efeitos adversosRESUMO
Angiostrongylus cantonensis produces eosinophilic meningitis in humans and is endemic in Thailand, Taiwan, China, and the Caribbean region. During infection with this parasite, it is important to know if the complement system may be activated by the classical or lectin pathway. Cerebrospinal fluid and serum samples from 20 patients with meningitic angiostrongyliasis were used to quantify C4 levels and albumin. Results were plotted on a C4 CSF/serum quotient diagram or Reibergram. Twelve patients showed intrathecal synthesis of C4. Antibody-dependent complement cytotoxicity should be considered as a possible mechanism that destroys third-stage larvae of this helminth in cerebrospinal fluid of affected patients.
Assuntos
Angiostrongylus cantonensis , Complemento C4/líquido cefalorraquidiano , Eosinofilia/parasitologia , Meningite/líquido cefalorraquidiano , Meningite/parasitologia , Infecções por Strongylida/líquido cefalorraquidiano , Adolescente , Adulto , Animais , Anticorpos Anti-Helmínticos , Criança , Pré-Escolar , Complemento C4/metabolismo , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Feminino , Humanos , Lactente , Masculino , Meningite/sangue , Infecções por Strongylida/sangue , Adulto JovemRESUMO
La infección por el nematodo Angiostrongylus cantonensis es la causa mßs frecuente de meningoencefalitis eosinofílica. La mayoría de los casos aparecen de forma aislada aunque se han descrito numerosos brotes epidémicos. Describir las manifestaciones clínicas y las características del líquido cefalorraquídeo y otros exámenes complementarios de 11 pacientes con diagnóstico de meningoencefalitis eosinofílica. Se trata de un estudio de serie de casos, de 11 enfermos admitidos en el Hospital General Universitario Dr Gustavo Aldereguía Lima con el diagnóstico de meningoencefalitis eosinofílica. Estos pacientes provenían de un mismo centro de trabajo, situado en un área rural, y sus síntomas clínicos coincidieron en el tiempo (enero-febrero 2006). Los síntomas predominantes fueron cefalea persistente (100 por ciento), parestesias e hiperestesias cutáneas (100 por ciento), mialgias (45 por ciento), trastornos visuales (45 por ciento), rigidez nucal (18 por ciento), parálisis facial periférica en 2 casos (18 por ciento). Solo un enfermo refirió fiebre. El diagnóstico de meningoencefalitis por A. cantonensis debe sospecharse en todo enfermo con cefalea persistente, parestesias e hiperestesias, aun en ausencia de fiebre y rigidez nucal. La presencia de eosinofilia en sangre periférica asociada a los síntomas anteriores sugiere el diagnóstico. La pleocitosis con un porcentaje elevado de eosinófilos es característico de esta enfermedad, pero la ausencia de eosinófilos en el líquido cefalorraquídeo no niega el diagnóstico. Es frecuente que ocurra en alguna etapa un predominio de linfocitos. Con la descripción de esta serie de casos se presenta el primer reporte de un brote epidémico de meningoencefalitis eosinofílica ocurrido en Cuba.
The infection by nematode Angiostrongylus cantonensis is the most frequent cause of eosinophilic meningoencephalitis. Most of cases occur in isolation although numerous outbreaks have been described. To describe the clinical manifestations and the characteristics of the cerebrospinal fluid and other supplementary exams from 11 patients diagnosed as eosinophilic meningoencephalitis carriers. A case study of eleven patients diagnosed with eosinophilic meningoencephalitis and admitted to Dr Gustavo Aldereguía Lima general university hospital. These patients worked at the same workplace located in a rural area and their clinical symptoms appeared in the same period of time (january to february, 2006). Predominant symptoms were persistent headache (100 percent of cases 9, cutaneous paresthesia and hyperesthesia (100 percent), myalgias (45 percent), impaired vision (45 percent), neck rigidity (18 percent), peripheral facial paralysis in two cases (18 percent). One single patient said that he had got fever. Meningoencephalitis caused by A. cantonensis should be suspected whenever a person suffers from persistent headache, paresthesias and hyperesthesias, even when neither fever nor neck rigidity is declared. Eosinophilia in peripheral blood associated to previous symptoms may indicate such a diagnosis. Pleocytosis, in which the percentage of eosinophils is high, is a characteristic of this disease; however, the lack of eosinophils in the cerebrospinal fluid does not reject this diagnosis. It is frequent that at some stage, lymphocytes will be predominant. The description of this case study allows us to present the first report of an outbreak of eosinophilic meningoencephalitis occurred in Cuba.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Angiostrongylus cantonensis/patogenicidade , Eosinofilia/diagnóstico , Eosinofilia/líquido cefalorraquidiano , Meningoencefalite/diagnóstico , Meningoencefalite/líquido cefalorraquidianoRESUMO
INTRODUCTION: Angiostrongylus cantonensis meningoencephalitis is an emergent disease in the Americas. METHOD: Twelve children suffering from eosinophilic meningoencephalitis due to this parasite aged between 6-10 years were studied. Cerebrospinal fluid (CSF) and serum samples were taken simultaneously in the first diagnostic puncture at admission. RESULTS: All cases showed typical findings on the routine CSF and serum analysis: increased CSF total protein, increased Q (CSF/serum) albumin accompanied by eosinophilia in CSF. No intrathecal synthesis of immunoglobulins was found. Mean serum and CSF sICAM-1 values were 337.4 and 3.97 ng/mL. Qalbumin and QsICAM-1 mean values were 4.1 and 6.2 respectively. In 50% of the patients an increased brain-derived fraction of sICAM-1 was found. CONCLUSION: It may be suggested that a dynamic of the sICAM-1 brain derived fraction is perhaps associated to the immune response in the evolution of the disease.sICAM-1 may be an agent in negative feedback for eosinophils passage through the blood-CSF barrier into the inflammatory brain response.
Assuntos
Angiostrongylus cantonensis , Eosinofilia/parasitologia , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Infecções por Strongylida , Animais , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Criança , Ensaio de Imunoadsorção Enzimática , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Humanos , Meningoencefalite/sangue , Meningoencefalite/líquido cefalorraquidiano , Infecções por Strongylida/sangue , Infecções por Strongylida/líquido cefalorraquidiano , Infecções por Strongylida/parasitologiaRESUMO
INTRODUCTION: Angiostrongylus cantonensis meningoencephalitis is an emergent disease in the Americas. METHOD: Twelve children suffering from eosinophilic meningoencephalitis due to this parasite aged between 6-10 years were studied. Cerebrospinal fluid (CSF) and serum samples were taken simultaneously in the first diagnostic puncture at admission. RESULTS: All cases showed typical findings on the routine CSF and serum analysis: increased CSF total protein, increased Q (CSF/serum) albumin accompanied by eosinophilia in CSF. No intrathecal synthesis of immunoglobulins was found. Mean serum and CSF sICAM-1 values were 337.4 and 3.97 ng/mL. Qalbumin and QsICAM-1 mean values were 4.1 and 6.2 respectively. In 50 percent of the patients an increased brain-derived fraction of sICAM-1 was found. CONCLUSION: It may be suggested that a dynamic of the sICAM-1 brain derived fraction is perhaps associated to the immune response in the evolution of the disease.sICAM-1 may be an agent in negative feedback for eosinophils passage through the blood-CSF barrier into the inflammatory brain response.
INTRODUCCION: La meningoencefalitis por Angiostrongylus cantonensis es una enfermedad emergente en las Américas. MÉTODO: Doce niños con meningoencefalitis eosinofílica por Angiostrongylus cantonensis con edades entre 6 y 10 años fueron estudiados. Se tomaron muestras simultáneas de suero y líquido cefalorraquídeo (LCR) en la primera punción lumbar diagnóstica. RESULTADOS: Todos los casos evidenciaron hallazgos típicos en los análisis de rutina del LCR y suero: incremento de proteínas totales, aumento de la razón albúmina Q (LCR/suero) acompañado de eosinofilia en LCR. No se encontró síntesis intratecal de inmunoglobulinas. Los valores medios de sICAM-1 en suero y LCR fueron de 337,4 y 3,97 ng/mL respectivamente. Los valores medios de Q albúmina y Q sICAM-1 fueron de 4,1 y 6,2 respectivamente. En el 50 por ciento de los pacientes se encontró un incremento de la fracción de sICAM-1 derivado del cerebro. CONCLUSION: Se puede sugerir que la dinámica de la fracción sICAM-1 derivada del cerebro ocurre quizas asociada a la respuesta inmune frente a la enfermedad. sICAM-1 puede ser un agente de retroalimentación negativa para el paso de eosinófilos de la sangre a través de la barrera sangre-LCR en el cerebro inflamado.
Assuntos
Humanos , Animais , Criança , Angiostrongylus cantonensis , Eosinofilia/parasitologia , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Infecções por Strongylida/parasitologia , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Meningoencefalite/sangue , Meningoencefalite/líquido cefalorraquidiano , Infecções por Strongylida/sangue , Infecções por Strongylida/líquido cefalorraquidianoAssuntos
Serviços de Diagnóstico/normas , Eosinofilia/diagnóstico , Meningoencefalite/diagnóstico , Angiostrongylus cantonensis/isolamento & purificação , Animais , Anti-Helmínticos/uso terapêutico , Cuba , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/parasitologia , Humanos , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Infecções por Strongylida/complicações , Infecções por Strongylida/diagnóstico , Infecções por Strongylida/tratamento farmacológicoRESUMO
INTRODUCTION: Eosinophilic meningoencephalitis is characterized by a meningeal syndrome and an eosinophilic reaction of the cerebrospinal fluid (CSF). When these symptoms persist for more than four weeks, it is said to be chronic. Both eosinophilic meningoencephalitis and chronic meningoencephalitis are of multiple aetiologies, including fungi. CLINICAL CASE: We report a case in which chronic meningoencephalitis occurred, with persistence of leukocytes, mainly eosinophils, in the CSF. The patient complained of intense, generalized headache and a temperature of 37 degrees C. On physical examination, the only unusual finding was slight neck stiffness. During the clinical course there were focal motor signs and evidence of intracranial hypertension. On CSF culture Candida guillermondii was grown. Treatment with amphotericin B was given, and the neurological disorder remitted completely. CONCLUSION: Candida guillermondii may be the etiological agent in chronic eosinophilic meningoencephalitis.
Assuntos
Candida/isolamento & purificação , Candidíase/complicações , Eosinofilia/complicações , Meningoencefalite/complicações , Meningoencefalite/microbiologia , Adolescente , Anfotericina B/uso terapêutico , Antibacterianos/uso terapêutico , Doença Crônica , Eosinofilia/líquido cefalorraquidiano , Humanos , Masculino , Meningoencefalite/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
Cerebrospinal fluid from 53 patients with clinical evidence of neurocysticercosis and 11 who suffered from several diseases were studied to evaluate the behaviour of indirect immunofluorescence test and some parameters of routine analysis. In neurocysticercosis there were pleocytosis in 88.7% of cases, eosinophilorrachia in 60.3%, hyperproteinorrachia in 71.7% and hypoglucorrachia in 13.2%. The indirect immunofluorescence test was positive in 79.2% of cases but false-positive results were found when the samples showed xanthochromia or erythrocyte contamination. The authors discuss their results in comparison with those in literature and conclude that the immunofluorescent test is sensitive and useful in diagnosis of neurocysticercosis, except when the interferents previously mentioned are present.
Assuntos
Encefalopatias/líquido cefalorraquidiano , Cisticercose/líquido cefalorraquidiano , Imunofluorescência , Adolescente , Adulto , Idoso , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Diagnóstico Diferencial , Eosinofilia/líquido cefalorraquidiano , Feminino , Glucose/líquido cefalorraquidiano , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
It is presented a case of a patient with a cerebral malignant astrocytoma in which the spinal fluid cytomorphology showed numerous eosinophilic granulocytes.
Assuntos
Neoplasias Encefálicas/líquido cefalorraquidiano , Eosinofilia/líquido cefalorraquidiano , Glioblastoma/líquido cefalorraquidiano , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A presença de grnaulócitos cosinófilos associados a tumores malignos que acometem o sistema nervoso tem sido raramente comunicada. O propósito deste registro é apresentar o caso de um paciente com 47 anos de idade com tumor cerebral maligno (astrocitoma grau III), cujo estudo citológico do LCR revelou quadro inflamatório com presença de elevada percentagem de granulócitos cosinófilos