Case report: Protracted eosinophilic meningitis due to probable angiostrongyliasis

Abstract

Eosinophilic meningitis is classically caused by Angiostrongylus cantonensis. Treatment usually includes supportive care and corticosteroids. Anthelminthic drugs are often avoided because of the risk of an inflammatory reaction to dying larvae. The duration of symptoms in most cases is up to a few weeks. We describe a case of eosinophilic meningitis, likely due to Angiostrongylus spp. infection, with recurrent symptoms and persistent cerebrospinal fluid eosinophilia despite corticosteroid treatment, over a period of almost 5 months. This only resolved after treatment with albendazole.