• Guoqing Qiu, Liqun Zhu, Sida Chen, Na Li, Chunxing Ye, Songming Zhuo, and Yan Shen.
• Respiratory Department, Longgang Central Hospital, Shenzhen, China.
• Medicine (Baltimore). 2023 May 12; 102 (19): e33683e33683.

RationaleHuman infection with Angiostrongylus cantonensis is uncommon and has only been sporadically reported in the literature. Patients infected with A cantonensis usually have a delayed diagnosis and sometimes a poor prognosis.Patient ConcernsA 70-year-old woman presented to the respiratory department with complaints of headache, chest pain, myalgia, fatigue, and anorexia for 7 days.DiagnosesComplete blood count showed eosinophilia. The serum was tested showing a positive finding of A cantonensis antibody. Cerebrospinal fluid was tested using high-throughput metagenomics analysis and 16 reads for A cantonensis were mapped. The patient was diagnosed with A cantonensis infection.InterventionsThe patient received a 7-day course of albendazole and 4-day course of prednisone.OutcomesWhen discharged from the hospital, the patient still suffered from fatigue and poor memory. Aminotransferase levels were high due to albendazole's liver toxicity. In a post-discharge follow-up about 1 month later she had recovered completely both physically and mentally, and peripheral eosinophil count and aminotransferase levels were both normal.LessonsBecause the direct identification of parasites is difficult, high-throughput metagenomics analysis may provide a reliable alternative tool for the diagnoses of infection with A cantonensis. When albendazole is prescribed, caution must be taken with respect to its liver toxicity.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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