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Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species

Lynn Ramirez-Avila1, Sally Slome, Frederick L Schuster

  • 1Division of Infectious Diseases, Children's Hospital Boston, Boston, Massachusetts 02115, USA. lynn.ramirez@tch.harvard.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 7, 2009
PubMed

Insights

Eosinophilic meningitis can stem from infections like Angiostrongylus cantonensis and Gnathostoma spinigerum. Early diagnosis and treatment are crucial for managing these severe CNS infections, especially with increasing travel.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Eosinophilic meningitis presents diverse etiologies, including infectious and noninfectious causes.
  • Angiostrongylus cantonensis and Gnathostoma spinigerum are leading infectious agents.
  • Increased international travel and immigration heighten the clinical relevance of these parasitic infections in non-endemic regions.

Observation:

  • Both Angiostrongylus cantonensis and Gnathostoma spinigerum infections can lead to severe central nervous system (CNS) compromise.
  • Diagnosis is frequently clinical due to limited availability of specific serological assays in the United States.
  • Conflicting treatment recommendations exist for both angiostrongyliasis and gnathostomiasis.

Findings:

  • This review highlights the clinical severity of eosinophilic meningitis caused by A. cantonensis and G. spinigerum.
  • The study emphasizes diagnostic challenges and the need for increased awareness of these helminthic infections.
  • Case descriptions and reviews aid in understanding the emerging nature of these diseases.

Implications:

  • Enhanced diagnostic strategies and readily available serological assays are needed.
  • Standardized treatment guidelines for angiostrongyliasis and gnathostomiasis are essential.
  • Clinicians should consider these parasitic infections in patients with eosinophilic meningitis, particularly those with relevant travel history.

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