Abstract

EOSINOPHILIC MENINGITIS – A CASE REORT FROM A TERTIARY CARE HOSPITAL IN KERALA

Ria Raju Thomas*, Resni Reji, Riya Antony, Sandra George, Tomy Philip and Santhosh M. Mathews

ABSTRACT

Eosinophilic meningitis is an infrequent clinical occurrence that can consolidate the differential diagnosis of central nervous system infections. It is defined by the presence of 10 or more eosinophils/μL in the cerebrospinal fluid (CSF) or a CSF eosinophilia of at least 10%. The most common cause of infection is helminthic parasites, particularly, Angiostrongylus cantonensis, but other infectious and noninfectious causes have also been identified. Angiostrongylus cantonensis is a nematode parasite whose infective larvaes are found in certain snails and monitor lizard (Varanus bengalensis). Infections in humans are due to ingestion of raw or partially cooked snails or monitor lizard. A case of a 31year old male with eosinophilic meningitis acquired as a result of consuming meat of monitor lizard is presented here. Initially the patient presented with classical symptoms of meningitis and he was empirically treated with meningitic doses of antibiotics. Since he showed inadequate response to the antibiotic therapy, a CSF analysis was sought which showed CSF eosinophilia. Presence of CSF eosinophilia and history of intake of meat of monitor lizard confirmed the diagnosis of eosinophilic meningitis.

Keywords: Eosinophilic meningitis, Angiostrongylus cantonensis, CSF eosinophilia.