Presumed parasitic meningoencephalitis following fresh snail exposure: physiotherapy interventions and functional outcomes in two distinct families and one solo case.

BACKGROUND

Meningoencephalitis can arise from several infections, but those linked to the parasitic infection Angiostrongylus cantonensis are uncommon. This parasite, often transmitted through consuming raw or undercooked snails, can cause severe neurological complications. This case series highlights physiotherapy management of neurological sequelae in children with presumed parasitic exposure associated meningoencephalitis.

CASE PRESENTATIONS: Five pediatric cases of presumed parasitic meningoencephalitis temporally associated with raw snail consumption are presented. All patients were Yoruba children from Southwest Nigeria. Two familial clusters were observed, involving a 9 year old boy and a 5 year old boy in one family, and a 5 year old boy and an 8 year old boy in a second family, alongside one isolated case involving a 9 year old girl. One patient died within 24 h of admission. All five cases received initial medical management, including anti-parasitic and supportive care. All surviving patients received medical and supportive care, while physiotherapy was initiated early to manage neurological impairments including muscle weakness, mobility limitations, and functional deficits. Interventions included range of motion exercises, strengthening, soft tissue techniques, transfer training, gait re-education, and desensitisation strategies for sensory disturbances.

CONCLUSIONS

These cases highlight the importance of preventive public health education on zoonotic exposure risks associated with snail consumption. Physiotherapy may play a supportive role in improving functional outcomes in children with neurological deficits secondary to presumed parasitic meningoencephalitis, particularly in resource limited settings.