Eosinophilic meningitis in New Caledonia: The role of Angiostrongylus cantonensis?

PLoS One. 2021 Aug 12;16(8):e0254964. doi: 10.1371/journal.pone.0254964. eCollection 2021.

Abstract

Introduction: Eosinophilic meningitis is a rare form of meningitis with sequelae or death occurring in approximately 2-3% of cases. The most frequent etiological agent is the parasite Angiostrongylus cantonensis. The aim of this study was to characterize New Caledonian cases and to assess the extent to which of A. cantonensis was involved.

Material and methods: We performed a retrospective study of all cases of eosinophilic meningitis (EM) admitted to the Territorial Hospital of New Caledonia, from 2004 to 2019. We performed a descriptive and a multivariate analysis to identify association of variables with severe and fatal cases (or cases with sequelae).

Conclusion: Angiostrongyliasis was confirmed as being responsible for 17 of the 92 reported EM cases in New Caledonia from 2004 to 2019 with most being young adults and non-walking infants, and with two peaks of incidence one during the dry season and one during the rainy season. Considering the high incidence and regularity of cases, the potential reservoirs should be identified to target prevention campaigns.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiostrongylus cantonensis / physiology*
  • Animals
  • Child
  • Child, Preschool
  • Eosinophils / pathology*
  • Female
  • Humans
  • Incidence
  • Male
  • Meningitis / epidemiology*
  • Meningitis / parasitology*
  • Middle Aged
  • Models, Biological
  • New Caledonia / epidemiology
  • Rain
  • Seasons
  • Severity of Illness Index
  • Young Adult

Grants and funding

The authors received no specific funding for this work.