title: Severe eosinophilic meningitis owing to Angiostrongylus cantonensis in young Jamaican children: case report and literature review.
abstract: Eosinophilic meningitis caused by Angiostrongylus cantonensis is an endemic and emerging disease that affects adults and children in Jamaica. Most cases resolve without sequelae, but young children are at high risk of neurological damage and death. Treatment with corticosteroids and albendazole is considered safe for adults and children, but protocols for its use in children have not been established. A 19-month-old infant with permanent neurological sequlae caused by Angiostrongylus cantonensis meningitis is reported, and five other Jamaican cases are summarized. A review of the literature of children with permanent neurological sequlae and death is presented. Children <5 years (especially <2) were at increased risk of incomplete recovery and death if they presented with bulbar signs, flaccid paresis and coma. None of the severe or fatal cases received early intervention with anthelminthics, and disease progression was not altered with corticosteroids. In view of the pathophysiology, necropsy reports and animal studies, it seems that the early use of larvicidals may change the course of severe presentations.
authors.forename: Tracy
authors.initials: T
authors.lastname: Evans-Gilbert
authors.forename: John F
authors.initials: JF
authors.lastname: Lindo
authors.forename: Sonia
authors.initials: S
authors.lastname: Henry
authors.forename: Paul
authors.initials: P
authors.lastname: Brown
authors.forename: Celia D C
authors.initials: CD
authors.lastname: Christie
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D017185:Angiostrongylus cantonensis / Q000302:isolation & purification*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019353:Endemic Diseases; D004802:Eosinophilia / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D007563:Jamaica / Q000453:epidemiology; D008581:Meningitis / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D017206:Strongylida Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D016019:Survival Analysis
chemical_list: D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D000893:Anti-Inflammatory Agents
keywords: Angiostrongylus cantonensis,; Children; Eosinophilic,; Infectious disease,; Meningitis,; Severe,