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Acute cysticercal meningitis in children: response to praziquantel
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Abstract:
Acute purulent meningitis as a manifestation of cerebral cysticercosis is uncommon. We report two children aged 12 months and 3 years who presented with clinical signs of acute meningitis and whose initial cerebrospinal fluid (CSF), except for negative culture, was typical of purulent meningitis. However, eosinophils were present in subsequent examinations of the CSF and the haemagglutination titre for cysticercus rose. Praziquantel was given to both children with dramatic improvement in clinical and CSF findings.
Insights
Cerebral cysticercosis can present as acute purulent meningitis, a rare condition. Treatment with praziquantel led to significant clinical and cerebrospinal fluid (CSF) improvement in two pediatric cases.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Cerebral cysticercosis is a parasitic infection of the central nervous system.
- Acute purulent meningitis is an uncommon manifestation of cerebral cysticercosis.
Observation:
- Two children, aged 12 months and 3 years, presented with symptoms of acute meningitis.
- Initial cerebrospinal fluid (CSF) analysis showed signs of purulent meningitis, with negative cultures.
- Subsequent CSF examinations revealed eosinophils, and serological tests showed a rise in cysticercus antibody titers.
Findings:
- The presence of eosinophils in CSF and elevated cysticercus antibody titers indicated a parasitic etiology.
- Praziquantel administration resulted in a dramatic improvement in both clinical symptoms and CSF findings.
Implications:
- This case series highlights the importance of considering cerebral cysticercosis in the differential diagnosis of acute meningitis, especially in endemic areas.
- Early diagnosis and treatment with praziquantel can lead to favorable outcomes in pediatric patients.